Permit Plbg 44 Dewees Ave 2012 Lfe^l
: 4 1 ry , > CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
rj J
Z.` ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
N C
Application Number 12- 00000192 Date 2/16/12
Property Address 44 DEWEES AVE
Application type description PLUMBING ONLY
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
1 fixture
Owner Contractor
MARTIN SANDRA L PLUMB -PAL, INC.
44 DEWEES AVE 1728 SABLE PALM LANE
PO BOX 330500 JAX BEACH FL 32250
ATLANTIC BEACH FL 32233 (904) 246 -8856
Permit PLUMBING PERMIT
Additional desc .
Permit Fee . . 62.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 8/14/12
Other Fees STATE PLBG DCA SURCHARGE 2.00
STATE PLBG DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 62.00 62.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 66.00 66.00 .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
JOB ADDRESS: l (( p c , ,,r E5 PERMIT #
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 L /
RE -PIPE:
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank & Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop ink
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
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 fmal inspection. **
❑ Other 6 -- / - <s") Sc2�`�� cek...____
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 prov sions of any other state or local law regulation construction or the performance of construction.
Property Owners Name C 4 21 s 4Th h (rz 1 1..J Phone Number
II
Plumbing Company r ✓v b - (9/31. s^'� - Office Phone ? YC -8R-5 Fax ,L//-
Co. Address: / 7 Z.0 S 4-C C Pe (,.'l (., , . City J ra_x r- 2 7 ,c (_ State ( _Zip 3 22.43
License Holder (Print): /vi . 4 ( CIey cr t-&__ State Certification/Registration # C FC oS7 .C7J'
Notarized Sia , . •, o L'ce e Holder _
, iis _. COMMISSION rn and_`: scribed befer- this f� i 2
=.r r_ MY COMMISSION N DD �, - r da o �� 20
z.;,:. r EXPIRES: February 14, 2014 _, . /
%'?pe Bonded Thru Notary Public uglisMtat_re of Notary Public = ��
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