Loading...
Permit Plbg Septic to Sewer 1432 Camelia 2011 j !.2'\x`1 �. . � ' ` s CITY OF ATLANTIC BEACH r ' : � ) 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5814 Z 01119' Application Number . . . . . 11- 00002976 Date 12/07/11 Property Address 1432 CAMELIA ST Application type description PLUMBING ONLY Property Zoning TO BE UPDATED Application valuation . . . 0 Application desc septic to sewer Owner Contractor OVERBY JOHN MOON PLUMBING 1432 CAMELIA STREET 1103 PALM CIRCLE ATLANTIC BEACH FL 32233 JAX BEACH FL 32250 Permit PLUMBING PERMIT Additional desc . Permit Fee . . . 62.00 Plan Check Fee .00 Issue Date . . . Valuation . . . . 0 Expiration Date . 6/04/12 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 Seminole Rd Atlantic Beach, FL 32233 / . Ph (904) 247 -5826 Fax (904) 247 - 5845 . 1/ _, JOB ADDRESS: '( -e& . PERMIT # 2176 NEW OR REPLACEMENT INSTALLATION: Project Value $ TYPE OF FIXTURE QTY TYPE OF FIXTURE 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 Qry 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 M CELWVid �S: S ewer Replacement " ❑ - flack Flow Preventer El Grease Interceptor (Trap) gallons (Requires 3 sets of plans) ❑ Lawn Sprinkler System - Number of Heads © Well ** ** SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection. ** ❑ Other 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 laws and ordinances governing this work will be complied with whether specified or not. The permit does not give authori to violate the rovisions of y other state or local law regulation construction or the performance of construction. Property Owners Name Q Phone Number Plumbing Company "4"er L'' fIi Q�,� Auj7LIOffice Phone J -)7. ax Co. Address: 81 .3 - L-he\ 6-t de-- City 4 7 Stated Zip' 22 License Holder (Print): '1 _ a J C -GD :t . � St ate C e rt ification/Registration # /77,ro Notarized Signatur • AW7 /tai 5 ini% SHIRLEY L GRAN .0 EZ a ' ,A. MY coMMI I , r s # scribed befo e t ■ ,,1 7 d. - o e. 20 /1 ^ ..w ds' EXPIRES: February 14, 0 4 r pF :. Bonded Thru N Public Underwrite y Public , —. is. T Y , .� •`'-. — rrrn►_e� • otar ' i