Permit Plbg 363 Atl Unit 13 2012 0,,,,,y,,,„
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CITY OF ATLANTIC BEACH
, , 0- s) 800 SEMINOLE ROAD
` " ,4, 4 ,, S, °` "` ATLANTIC BEACH, FL 32233
�; INSPECTION PHONE LINE 247 -5814
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Application Number 12- 00000125 Date 1/31/12
Property Address 363 ATLANTIC BLVD UNIT 13
Application type description PLUMBING ONLY
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
3 compartment sink
Owner Contractor
SHOPPES OF NORSHORE LLC FENWICK, BILL PLUMBING, INC.
P.O. BOX 330108 8245 BEACH BOULEVARD
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32216
(904) 724 -7022
Permit PLUMBING PERMIT
Additional desc .
Permit Fee . . . 69.00 Plan Check Fee .00
Issue Date Valuation . . . . 0
Expiration Date . . 7/29/12
Other Fees STATE PLBG DCA SURCHARGE 2.00
STATE PLBG DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 69.00 69.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 73.00 73.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
LI 14 r 2 `1133
PL
UMBING PERMIT APPLICATION
1b 'gar* F rY n1 CI a-k
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph (904) 247 -5826 Fax (904) 247 -5845
JOB ADDRESS: x(93 6 r 1 C Pj1 v C\ , St. )1 1 PERMIT #
RA V\ c "Read 1 v L 32- 23 3
NEW OR REPLACEMENT INSTALLATION: Project Value $
TYPE OF FIXTURE QTY TYPE OF FIXTURE 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 1 Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
RE -PIPE:
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank & Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink I
Floor Sink Toilet
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures
Water Treating System
MISCELLANEOUS:
❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor (Trap) gallons (Requires 3 sets of plans)
❑ Lawn Sprinkler System- Number of Heads ❑ Well * *
** SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection. **
❑ Other
Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months. I hereby certify that I have read
this application and know the same to be true and correct. All provisions of laws and ordinances governing this work will be complied with whether specified
or not. The permit does not give aut ority to violate the provisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name J G ')n V h i.tta.-r - ‘, 9C_Ltrn - >ei C r°r P.r Phone Number 3 3 3 - G (09
Plumbing Compan I ♦ I I 1 €r Lut t P 1 t . LL ( , Office Phone QOLI '?c-I') C22 Fax `la s 5
Co. Address: t a j -.. A(vd
City j c-g- State rl Zip 32 -'2-1C'
L' nse Holder (Print): - 11 State Certification/Registration # CFCOL RJ3 '
1 _ .irized Signature of License Holder . �. x t t..*. LCD
Sworn and subsc ' ed before me this day of J O nuctA44 20 1 a--
� � , F yy� r1i ? BROOKE F DOWNING UU
° '1 MY COMMISSION 0 EE143391 Si nature of Notar j
g y Public �� " �-�' ��
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- . EXPIRES November 02, 2015
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