Permit Plbg Sewer 120 Mayport #26 2011 IC BEACH
CITY OF ATLANT
800 SEMINOLE ROAD
ANTIC BEACH,FL 32233
LINE 247-5814
INSPECTION PHONE
r
Application Number . . . . . 11-00002935 Date 11/23/11
Property Address . . . . . . 120 MAYPORT RD 26
Application type description PLUMBING ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0 -----------------------
-----------------------------------------------------
Application desc
replace sewer service ---------------
-------------------------------------------------------------
Owner Contractor
------------------------
F.W. FAIR PLUMBING CO.
SINGELTONS TRAILER PARK P.O. DRAWER 51558
ATLANTIC BEACH FL 32233 JAX BEACH FL 32250
(904) 241-7191
----------------------------------------------------------------------------
Permit . . . . . . PLUMBING PERMIT
Additional desc . - . 00
Permit Fee . . . . 62 . 00 Plan Check Fee
Issue Date . . . . Valuation . . . . 0
Expiration Date . - 5/21/12 ---------------
---------------------------------------------------- -------
Other Fees . . . . . . . . . STATE PLBG DCA SURCHARGE 2 . 00
STATE PLBG DBPR SURCHARGE 2 . 00
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 62 . 00 62 . 00 . 00 . 00
Plan Check Total . 00 ' 00 . 00 . 00
Other Fee Total 4 . 00 4 * 00 . 00 . 00
Grand Total 66 . 00 66 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Serriinole Rd Atlantic Beach, FL 32233
Ph (904) 247-5826 Fax (904)247-5845 PERNUT
JOB ADDRESS: 2, AM YPk I- 1?2D (' t-r-�' '4
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE OF FIXTURE QTY TYPE oF FTXTURE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
RE-PIPE:
TYPE oF FIXTURE QTY TYPE oF FIXTURE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Stop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
MISCELLANIF,OUS:
kewer Replacement El Back Flow Preventer o Grease Interceptor (Trap) gallons(Requires 3 sets of plans)
S
0 Lawn Sprinkler System-Number of Heads o Well for fmal inspection."
SJRWD Well Completion Forrq. Completel-form to�be�submitted to the-Building Department
prc
Auther 6
Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months.I hereby certify that I have read
this application and know the same to be true and correct. All provisions of I and ordinances governing this work will be complied with whether specified
Zorm onstruoon.
or not The permit does not give authonity vi late the provis ns of an othr S or local law regulation construction or the & ce of c
( Phone Nunit , /V--� -
Property Owners Name Office Phone ax el 47
Plumbing Company
city Tif Stat/--b ZI
Co. Address: CU 3 ;�f
License Holder (Print): I State Certification/Registration
Notarized Signatu My 00 GRAHAM V, 20)
EXPIZWWAr� cribed bi�fo m this
Bonded Thru Notary Public U�'derwrite tary Publi