Permit Plbg Repipe 1660 Beach #3 2011 't - Al �-
� �� _ " � CITY OF ATLANTIC BEACH
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- _ # y 800 SEMINOLE ROAD
," ATLANTIC BEACH, FL 32233
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INSPECTION PHONE LINE 247 -5814
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Application Number 11- 00002969 Date 12/06/11
Property Address 1660 BEACH AVE UNIT #3
Application type description PLUMBING ONLY
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
12 fixtures
Owner Contractor
HART DAVID GRAY PLUMBING INC.
8850 CORPORATE SQUARE CT.
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32216
(904) 744 -7255
Permit PLUMBING PERMIT
Additional desc .
Permit Fee 139.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 6/03/12
Other Fees STATE PLBG DCA SURCHARGE 2.09
STATE PLBG DBPR SURCHARGE 2.09
Fee summary Charged Paid Credited Due
Permit Fee Total 139.00 139.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.18 4.18 .00 .00
Grand Total 143.18 143.18 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
Mar 08 10 12: 4p Information SystemsClTY 0 904-247 -5545 0.1
12:54p
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph (904) 247-5826 Fax (904) 247 -5845
SOB ADDRESS: /I- (, 3 UY
NEW OR REPLACEMENT INSTALLATION: Project Value e
TYPE OF FIXTURE OTY A'Y'E OF FIXTURE OT
Bathtub Septic Tank & Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Dram Three Compartment Sink
Floor Sink Toilet
Hose Bibs Uriaaa1
Vacuum Breakers
Laundry Sink
Laundry TraS W ater Connected Appliances
Water Heater
/�-- _ ` - 1 er Fi Water Treating System
( • � � er Fixtures
E OF FUTURE' ti
Bathtub Septic Tank & Pit
Clothes Washer l Shower
Dishwasher Shower Pan
Drinking Fountain Stop Sink
-
Floor )train Three Compartment Sink
2 oilet
Floor Sink Toilet
Hose Bibs
Kitchen Sink 1 Vacuum Breakers
Laundry Tray _ — Water Connected Appliances
Lavatory , , i' Water Heater
Other Fixtures Water Treating System
:'rf CELLANEOUS:
1..] Sewer R�lacement o Back Flow Presenter E Grease Interceptor (Trap) gallons (Requires 3 sets of Diaz %)
0 Lawn Sprinkler 5ystern= Number of Beads ❑ Well
.' W :S,RWD Well Completion Forrn. Completed. fox= to be submitted to the Building Department for tea? inspection.*''
❑ Other
i .�.. be es void fw work of ,.
' � nit becomes vmd if work does not commence within a six month period or work is suspended or abandoned for si,. months I hereby certify, that I have read
this application and know the same to be true and comet. All proviaious of laws and ordinances governing this work will be complied with whether :
c, ncr_ The permit does root give authority to violate the provisions of any other state or local law regulation construction cr the perfonnance of construction.
/� Phone Number C ?? �.5
�y ® Name /� 4 _ ��/ . C� .a LI L ���.s' � a � .� ':?
r't � Owners -
David -T = =wN Plumbing, Inc. office Pho l `" �•-_ F
Plumbing Company Office `7 ~ ~
8b .50 t, Ni it ,t, Square Cowl" City State Lip
C_.7, Address: ! �s�
u_ :icense.. 11okier (Priest.): fry/ s _ ,2P
State Certificesi ®nf egtsfratioa� C P 0 - .2...5../t
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_ ,00 •% Notary Public State of Florida • of _ � . - 20 1 �`^ Neal R Major :worn and subscr before me thi • y
�'��.. My Commission EE032510 �/i
fo,r�o Expires 12/20/2014 signature of Notary Public :�''�� / ' A
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