Permit Plbg 609 Beach 2012 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
�� a , �� ATLANTIC BEACH, FL 32233
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INSPECTION PHONE LINE 247 -5814
Application Number 12- 00000176 Date 2/10/12
Property Address 609 BEACH AVE
Application type description PLUMBING ONLY
Property Zoning TO BE UPDATED
Application valuation . . . 1000
Application desc
REPIPE ONE BATHROOM 4 FIXTURES
Owner Contractor
TAYLOR ROBERT CHRISTY FIRST COAST PLUMBING
609 BEACH AVENUE 1651 MAYPORT RD
ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233
(904) 247 -4419
Permit PLUMBING PERMIT
Additional desc . REPIPE 1 BATH
Permit Fee . . . 83.00 Plan Check Fee . . .00
Issue Date Valuation . . . . 0
Expiration Date . . 8/08/12
Other Fees STATE PLBG DCA SURCHARGE 2.00
STATE PLBG DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 83.00 83.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 87.00 87.00 .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 t
Ph (904) 247 -5826 Fax (904) 247 -5845
JOB ADDRESS: I p 0 �l i PERMIT # L2 — / -
NEW OR PLACEMENT INSTALLATION Project Value $
•
TYPE OF IXTU 1 TY TYPE OF FIXTURE QTY
Bathtub Septic Tank & Pit
Clothes Washer Shower
Dishwasher Shower Pan /
Drinking Fountain p
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 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 I 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 authority to violate the provisions of any other state or local law regulation construction or the
perform� of c gfistruction.
Property Owners Name Rob �Cc. (Or' Phone Number '` �' , * , ,
Plumbing Company('
h �r 1b51 Mayport Road
Office Phone o9474 9 Fax 44 — _ , 0
Co. Address: 009- fri ' '► k • Atlantic Beach, FL 32233 City State Zip •
License Holder (Print): P1 JO 1 / st: _ State C ' tion/Registration # ___
Notarized Signature of License o der # �� r
Sworn and subs'cri •4 , fore u - this /0 of 20 �
a`2 I
Signature of Notary Public ' ,(',( ��
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