Permit 646 Selva Lakes Cir 12/2011 water heater CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 11-00003042 Date 12/27/11
Property Address . . . . . . 646 SELVA LAKES CIR
Application type description PLUMBING ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
----------------------------------------------------------------------------
Application desc
1 fixture
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
BRAZA DAVID GRAY PLUMBING INC.
6491 POWERS AVENUE
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32217
(904) 724-7211
----------------------------------------------------------------------------
Permit . . . . . . PLUMBING PERMIT
Additional desc . .
Permit Fee . . . . 62 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 6/24/12
----------------------------------------------------------------------------
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.
Mar 08 10 12:54p Information SystemsCITY 0 904-247-5845 P.1
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904)247-5826 Fax(904)247-5845
JoB ADDREss: J�it_ K Y/1 01,C�,_ PERAUT#
NEW OR ACEMMNT INSTALLATION: Project Value $
TY—PE oF FjxmRE QTY TYPE oF FixTuRE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher 'Shower Pan
Drin�g Fountiin Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
'Urinal
Hose-Bibs
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatl�ry Water Heater
-0ther"Fixtures Water Treating System
RE-PIPE:
TYPE oF Fbaviw Qry TYPE oF FDavRE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
or-ak-ing Fountain S[op Sink
Three Compartment Sink
Floor ink Toilet
Rose Bibs _T73-11
Khchen SiJ*
Laundry Tray Water
Lavatc>ry Water Heater
Cfther Fixtures Water Treating Sy stem
NHSCELLANEOUS:
* Sewer Replacement 0 Back Flow Preventer o C-rease Interceptor(Trap) gallons(Requires 3 sets of plaw)
* Lawn Sprin1der System-Number of Heads o Well
SJRWD W4elf Ca Wetion Form. Completeci f4o to be submitted to tEe Building Department for final inspection.'
Ei Other
P=nit becomes-aid if work does not wrnmence wiihin a six month period or work is saspended or abandoned for six months.I hereby cce:tf-ythax
this application and know the same to be true and correct. All provsious;of laws and ordinances goveming this work will be
or noL I'r,.c pennit does mot eive authoriplite vickte theWV131 I ons of any other state or iocal law regulation construction if_c-,% _C)3=UCti0n.
0910�-,,f ,- Number
Property Owners-N3w_e
Plumbing Company '08Vid Gray Plum, bing, Inc. OffCf�7). '7j4-f-7kg�r Fax 1,13--5-10il
06611 PAu),rg 4vro -
Co. Address: City
I- tate fi- Zip ;JA�_ -1
a-49-S
#
License Rol-der(Print): State Certificati-on/Registmtion
Xotarized Sigmaturc of License Hoider— -d f _k_- .1 --- - 4-),
.-*. and subscribed before ithis; Of
Notary Public state of Florida cd] of 20-t/-
Neal R Major
My Commission EE032510 -,,-(ia=e of Notary Public
If Expires 12120120,4