Permit Plbg Repipe 2303 Fiddlers Ln 2012 ''t CITY OF ATLANTIC BEACH
s" 800 SEMINOLE ROAD
J ; _~ ATLANTIC BEACH, FL 32233
,A- - cry, INSPECTION PHONE LINE 247 -5814
Application Number 12- 00000177
Date 2/10/12
Property Address
2303 FIDDLERS LN
Application type description PLUMBING ONLY
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
PLUMBING REPIPE 17 FIXTURES
Owner Contractor
EBERT WILLIAM P J STEEG PLUMBING
2303 FIDDLERS LAN 1601 MAIN STREET
ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233
(904) 249 -5191
Permit PLUMBING PERMIT
Additional desc . REPIPE 17 FIXTURES
Permit Fee . . . 174.00 Plan Check Fee .00
Issue Date Valuation 0
Expiration Date . . 8/08/12
Other Fees STATE PLBG DCA SURCHARGE 2.61
STATE PLBG DBPR SURCHARGE 2.61
Fee summary Charged Paid Credited Due
Permit Fee Total 174.00 174.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 5.22 5.22 .00 .00
Grand Total 179.22 179.22 .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
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JOB ADDRESS: L� It-9� �it 'Y PERMIT rr
NEW OR REPLACEMENT INSTALLATION: Project Value $
TYPE OF FIXTURE OTY TYPE OF FIXTURE OTY
Bathtub Septic Tank & Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
FIoor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater .
44 er Fixtures Water Treating System
RE -PIPE:
TYPE OF FIXTURE OTY TYPE OF FIXTURE OTY
Bathtub 3 Septic Tank & Pit
Clothes Washer / Shower -- i
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet 3
Hose Bibs 2- Urinal
Kitchen Sink f Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory 5/ Water Heater __I
Other Fixtures Water Treating System
MISCELLANEOUS:
❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor (Trap) gallons (Requires 3 sets of pi:
❑ Lawn Sprinkler System - Number of Heads ❑ Well **
** SJRWD Well Completion Form. Completed follu to be submitted to the Building Department for final inspectioi
❑ 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
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 speci
or not. The permit does not give authority to violate the provisions of any other state or Iocal law regulation construction or the performance of constructs
Property Owners Name /� ' e ! , Phone Number
Plumbing Company 4 1/ rh Office Phone 0/90 Fa y / /�.3 j
Co. - • .- I _ /s , ` '5.7`" City Aft 0 State Zip 3-3
I °' ti ' DEBORAH AMANDA WHITE 1
Lis: d ei#v !�Eeos7 ,. m 1wc State Certification/Registration # e�e03 /y
itl��,, P ay r I it
/A�,/' Bon. Thru " • Underwrite . _, t �. !der _
Sworn at r, subscribe befor- i , its 4 / ( 919--- day t _JL i l i g - 20/.
•
Signature of Notary P ubli ll / ,/ _AX , /