1330 Ocean Boulevard 2011 water heater CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
C 111V
Application Number . . . . . 11-00003048 Date 12/28/11
Property Address . . . . . . 1330 OCEAN BLVD
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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PALEY, SEAN CHRISTY FIRST COAST PLUMBING
1330 OCEAN BLVD 1651 MAYPORT RD
ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233
(904) 247-4419
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Permit . . . . . . PLUMBING PERMIT
Additional desc . .
Permit Fee . . . . 62 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . - 6/2S/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 ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLumBwG PERmIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233
Ph(904)247-5826 Fax(904)247-5845 4M
JoB ADDREss: ce-94--, A Puumr#
NEW OR REPLACEMEW INSTALIATION: Project Value$
TYPE oF Fmmiw QTY TYPEoFFmwjw QTY
Bathtub i =V�ank&Pit
Clothes Washer
Dishwasher Shower Pan
�LFountain Slop Sink
Floor Three Compartment Sink
Floor Sink Toilet
HoseBibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tmy Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
RE-PEPE:
7)rPEoFFDrnrRE QTY TYPE oF Fbaum 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
MISCELLANEOUS-
o Sewer Replacement � Back Flow Preventer 11 Grease IntercePtOr CrraP) gallons(Requwa 3 sets of plans)
0 Lawn Sprinkler System-Number of Heads C1 Well
74-1,
SJRWD Well Completion Form. Completed form to be submitted to t—he—B Idd—ing Department for final irLspectiom**
rl Other
Permit becomes void irwork does not coninience withio a six month period or work is suspended or abandoned for six Mouft I hereby certify Uw I have read
this application and know the same to be true and correm All provisions of laws and ordinances governing this work will be complied with whether specified
or not. The permit does not give auth ity to violate the provisions of any other§tate or local law regulation construction or I)te pedbrmance of construction.
Property Owners Name -e-c-, Phone Nu="'r)4 3� -0
Plumbing Com"a"IT Aty 166J Maypod Road Office Phone--'M-44� Faxj:�Vj�—W"
Co.Address: Mante Beachl FL 32233city State zip
License Holder(Print): State cation/Registration#
wu6c 417
Noftriud Sknaftre License A
A
"p"", JUUE yOUNG CHR181Y Sworn and subscribee)9fore th� daY Of _0(�VXIV_ 2011
'TY
COMWON#DD 873M
E*1RESA*21,2DL13
9nftdedThrUN0t91YPftUftdV~ ignature of Notary I
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