Permit Plbg 2109 Fleet Landing 2012 j .rte J. c l
At,
1 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
t) ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
Application Number 12- 00000142 Date 2/03/12
Property Address 2109 FLEET LANDING BLVD
Application type description PLUMBING ONLY
Property Zoning TO BE UPDATED
Application valuation . . . 500
Application desc
Install connection for washing machine 1 fixture
Owner Contractor
NAVAL CONTINUING CARE LANCE MAXWELL PLUMBING, INC.
FLEET LANDING 5310 TOWER ROAD
1 FLEET LANDING BOULEVARD TALLAHASSEE FL 32303
ATLANTIC BEACH FL 32233
Permit W /W /O PLUMBING PERMIT
Additional desc . INSTALL WASHER VALVE
Permit Fee . . . 124.00 Plan Check Fee .00
Issue Date Valuation 0
Expiration Date . . 8/01/12
Other Fees STATE PLBG DCA SURCHARGE 2.00
STATE PLBG DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 124.00 124.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 128.00 128.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
/ Ph (904) 247 -5826 Fax (904) 247 -5845 -
.TOt3 ADDRESS: ! Q 7-4e7 . 1 - PERMLT # /4'9 / X2
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 Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
RE -PIPE:
TYPE OFFJXTURE Qr' 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 Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water ireating System
MISCELLANEOUS:
❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor (Trap) gallons (Requires 3 sets of plans)
❑ Lawn Sprinkler System- Number of Heads ❑ Well **
kX 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.1 hereby certify that, I have read
this application and know the same to be true and correct All provisions ()flaws and ordinances governing this work will be complied with whether specified
or not The permit dots not give authority to violate the provisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name i, %, ,J Phone Number Vt./ G( 7/
Plumbing Company — / �/ _ z AWOffiee Phone 4/5 ?Dziaxadyg.ZTB"S13
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6 09 crJ / /l9r i�r �.
Co. Address: e 5 �� /'v{ - City j0fyr/Pr� ad Slate Zip j/Z
License Holder (Print): _ i � , Mtate Certifi io e " tration # Notarized Signature of License Flolder r
se*, fi= l OMMI SIGN lusuix Sworn and subscribed before e this day of
My COMMISSION M DD 942536 r ,�,tcax� 20
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4 k _ Bonded EXPIRES: t 20 u„ae nw Signature of Notary Public )4.1iRCPUVY21 17
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CITY OF ATLANTIC BEACH
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BUILDING AND ZONING DEPARTI' i ENT i I
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This building has been inspected and:
General Construction rj Mechanical
1 Concrete and Masonry Electrical
EY Plumbing 1 1 Gas Piping
IS NOT ACCE ?' TED
CORRECT AS NOTED BELOW, BEFORE ANY FURTHER WORK
f it/ ni bin . e r , "/ i RV / 1 .e / . 10 BL 1 c
9 1 102V tv"e I I f /..y..., ___ ------------
DO NOT REMOVIE, rIfiffiltE ik.10'11TicEti
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Inspector: Date: )-- / —/ Z_
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Failure to respond to this Notice WitEivgi I(' fr,ayS ,.'$iiV4 ri'': ill 4 AN ViT)htlyil bg fOrVizardj(41
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CP ; 211 71 : 1 l's : , 0 .- 1: , '',
Thy po:,tifitY, of this tqacaid by ik coiticais -dial! , i.:1 - 1,:: as ciii,: a,iii(y