Permit Plbg Repipe 1961 W Sevilla 2011 i -; i r- J 0 � S CITY OF ATLANTIC BEACH
I t1 r 800 SEMINOLE ROAD
J -. ATLANTIC BEACH, FL 32233
'` 0 131 9"
INSPECTION PHONE LINE 247 -5814
Application Number 11- 00002975 Date 12/06/11
Property Address 1961 W SEVILLA BLVD
Application type description PLUMBING ONLY
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
REPIPE 12 FIXTURES
Owner Contractor
LINWICK LARRY TEAGUE & SONS
1961 SEVILLA BLVD.W. 203 OCEANFRONT
ATLANTIC BEACH FL 32233 NEPTUNE BEACH FL 32266
(904) 270 -2289
Permit W /W /O PLUMBING PERMIT
Additional desc .
Permit Fee • • . 278.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 6/03/12
Other Fees STATE PLBG DCA SURCHARGE 4.17
STATE PLBG DBPR SURCHARGE 4.17
Fee summary Charged Paid Credited Due
Permit Fee Total 278.00 278.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 8.34 8.34 .00 .00
Grand Total 286.34 286.34 .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 -58 5
JOB ADDRESS: 1 1 5 tv < 1 to1/4:Bou it.la..tcL #
2243
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 QTY
Bathtub 1 Septic Tank & Pit
Clothes Washer 1 Shower — 1 —
Dishwasher _I__ Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet 2-•
Hose Bibs 2..... Urinal
Kitchen Sink / Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory 2 Water Heater T
Other Fixtures Water Treating System '2
I
MISCELLANEOUS:
❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor (Trap) gallons (Requires 3 sets of plans)
❑ Lawn Sprinkler System - Number of Heads ❑ Well **
** SIRWD 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 giv au ority t violate the�previsions of y other state or Local law regulation construction or the performance ce of construction.
Property Owners Name � L -i n - Phone Number 3 +3 —3521-- Plumbing Company l+.r r ' , Co 41.'' S011 1 . UIbb, lce Phone 2-7°"21 FaxL4
Co. Address: 2-3 0 -F li `' ' t City tate a Zip License Holder (Print): 1'V n 01 ,& ' i State - • ication/Registration # 2...i 5 2 q
Notarized Signature of Lice older T we,
°ti Notary Public State of Florida Sworn and subscribed before this
Y�
r � Lin E Maple day of "`anWAPJ^ 20
k7 My Commission DD850194
40, o p* Expires 01 /0 8120 1 3 Signature Of Notary Public
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NOT Cad VF r ' fl s NOTICE b
DO ;:
ry 1 . S.
Inspector. ' ,� l (i I)ate• 's / m ■
0
Failure to respond to this Notiet \ aitiii 40 tY413. :, w` i kt,;ttit ill this r'io!Yttion beingft)rwar(led
C10 1 ENFORCEMENT it()AI•tI).
` `. Thepostin g of this P1 c.+rd by it, crnitents shall serv as clue notice.
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