Permit Plbg Repipe 225 11th St 2012 4 `, CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
J ; Zs ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
p
Application Number 12- 00000012 Date 1/05/12
Property Address 225 11TH ST
Application type description PLUMBING ONLY
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
repipe 14 fixtures
Owner Contractor
HARRIGAN, TRAVIS DAVID GRAY PLUMBING INC.
225 11TH ST 6491 POWERS AVENUE
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32217
(904) 724 -7211
Permit PLUMBING PERMIT
Additional desc .
Permit Fee . . . 153.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 7/03/12
Other Fees STATE PLBG DCA SURCHARGE 2.30
STATE PLBG DBPR SURCHARGE 2.30
Fee summary Charged Paid Credited Due
Permit Fee Total 153.00 153.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.60 4.60 .00 .00
Grand Total 157.60 157.60 .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 SystemsCfTY 0 904 -247 -5845 p.1
PLUMING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph (904) 247 -5826 Fax (904) 247 -5845
JOB ADDRESS: 221..)" I "iL PERMIT #
NEW OR REPLACEMENT INSTALLATION: Project Value $ tD.C •
TYPE OF FIXTURE QTY TYPE OFFIXTURE 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 FIXTEME QTY TYPE OF FIX E QTY
Bathtub 1 Septic Tank & Pit
Clothes Washer —�_ Shower —
Dishwasher —T- Shower Pan
Drinking Fountain ... Stop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet 4
Hose Bibs Urinal
Kitchen Sink ____r_— Vacuum Breaker
Laundry Tray � Water Connected Appliances
Lavatory 4 -- Water Heater ____i
Other Fixtures Water Treating System
MIISCELLANEOUS :
❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor (Trap) _ gallons (Requires 3 sets of pl as)
❑ Lawn Sprinkler System Number of Heads ❑ Well
* &TRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection. **
VOther . (, - 4, )Lid ' f tt 4 Pik -- _ -
..r„�.an., «•,..�..�.,..�e ,.... <.:. .::._. „ ... .... ...:... . M...•......b, >,,k..�� _� �,...�.,b . ,.
Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months. I hereby f certify that I have read
this application and know the same to be true and correct. All provisions of laws and ordinances governing this worlr will be complied with whether specified
or not The permit does not give auto to violate provisions of any other state or local law regulation construction or the performance of construction,
Property Owners Name 1 2d VI ' , i2.212a Phone Number "`cZko
Plumbing Company
Davy Gray y Plumbing, Inc. Office Phone 1 1` 7)- Fax > - '
885 C;or por,ate quare Court e
Co. Atiriress: , _ _ i, _ r, r .,,� � City State Zip
License Holder (Print): I/4V12 6:e191 State CertificationfRegistration # G FJ 0 ,v2-, ge
i
Notarized Signature of License Holder 1
. orn and subscribed before me this da of .0 • 1.. 20 I
r ot.sv °if4 Notary Public State of Florida
Neal R Major 4 .0 e of Notary Public t
I o My Commission EE032510
. ',.."„e O Expires 12/20/2014
4
•
."*.: