Permit 1904 Selva marina Dr 2011 plumb water heater CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 11-00003038 Date 12/27/11
Property Address . . . . . . 1904 SELVA MARINA DR
Application type description PLUMBING ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
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Application desc
1 fixture
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Owner Contractor
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CAROLYN R. JONES OWNER
273 MAGNOLIA STREET
ATLANTIC BEACH FL 32233
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Permit . . . . . . PLUMBING PERMIT
Additional desc . .
Permit Fee . . . . 62 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 6/24/12
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Other Fees . . . . . . . . . STATE PLBG DCA SURCHARGE 2 . 00
STATE PLBG DBPR SURCHARGE 2 . 00
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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 ALI, CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
Dec 27 11 01 : 47p Susan Parrish 904-246-3673 P. 1
PLUMBING PERMIT APPLICATION
CITY OF ATLANTic BEACH
30O.Serninole Rd Atlantic Beach,FL 32233
p h 904)247-5826 Fax(904)247-5845
h
JoBADDRM: PFAMrr#
NEW OR REPLACI&XMNT INSTALIATION: Project Value S
TYPEoFFLcmw U27 7WJ?0FFnCW'W (?TY
Bathtub Septic Tank&Pit
Clothes Wedwr Shower
Dishwasher Showerpan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bibs urinal
KitchenSink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fbaums Water Treating System
RF-PIPE:
TYPE oF ftamE QZT 2WEoFFnaTjRE qZY
Bathtub Septic Tank&Pit
Clothes Wa&hcr Shower
Dishwasher Shower Pon
Drin1dag Fbantaia Slop Sink
Floor Drain Tbree Compartment Sink
Floor Sink Toilet
Hose Bibs Urinal
Kftchca Siok Vacuum Breakers
Laundry Tray Water Conneow Appliances
Lavatory Water Brater
Other Fbcmres Water Treating System
MISCELLANEOUS:
13 Sewer Replacement 0 Back Flow Preventer Cl Grease Interceptor(Trap) gauons(Requires 3 sets of plans)
0 Lawn SpriWder System-Number of Heads 0 Well
**WWD Well Completion Form. Completed form to be submitted to 6�-Building Department for final inspection."
11 Other
?=nit becotnes void ifwork does not commence within it six mouth period or woTk is suspea(ledcrabandoned for six months.I hareby ocitifythat I�have read
this application and Imow the same to be vue and correct All provisions of laws and ordizunces governing this work will be complied,with wbedw specificd
or not 7"he pconit does not give w&ority to violate the provisi of 4h or local bw regulation onnstructiow or the perfommuce of construct
Property Owneis Name Me:2n42�� Phone Number
Plumbing Company of floe Phone Fax
zip�=
Co.Address: r city nfi State
License Holder(Print): All eikio h9rl*if-iA— LfLW1oa/Regj9tmtion# 61-1e-o 0
Notarked Signature of License Holder
IV
S
worn and subscribed re Me this VV day of 20,&_
DIANE 0.RjOCNE 4WL=of Notary Public 40,
111day Public-SIM of Fkft
MY CORIM.Expires Apr 15.2013
COmmIssiOn#DD 800918 JJ-)P1rJ -Immll- in k1r) nin- rt iin
Bonded Thmuo v*u w"Am.