Permit Plbg 5518 Rigel Ct 2012 4
, ,A CITY OF ATLANTIC BEACH
„' 800 SEMINOLE ROAD
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ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
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Application Number . . . . . 12- 00000200 Date 2/21/12
Property Address 5518 RIGEL CT
Application type description PLUMBING ONLY
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
11 FIXTURES
Owner Contractor
NAVAL CONTINUING CARE DAVID GRAY PLUMBING INC.
RETIREMENT FOUNDATION, INC 6491 POWERS AVENUE
1 FLEET LANDING BLVD JACKSONVILLE FL 32217
ATLANTIC BEACH FL 322334599 (904) 724 -7211
Permit PLUMBING PERMIT
Additional desc .
Permit Fee . . . 132.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 8/19/12
Other Fees STATE PLBG DCA SURCHARGE 2.00
STATE PLBG DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 132.00 132.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 136.00 136.00 .00 .00
1
I,
LAtP PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
Mar 08 10 12:54p Information SystemsC[TY 0 904 -247 -5845 p.1
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph ()4) 247 -5826 Fax (904) 247 -5845
JOB ADDRESS: j5I g Hat,. er PERMIT # / - 20
•
NEW OR REPLACEMENT INSTALLATION: Project Value $
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank & Pit
Clothes Washer Shower
Diish washer Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bibs Ur
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
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TAE OF FIXTURE QTY TIDE OF FIXTURE QTY
Bathtub / Septic Tank & Pit
Clothes Washer _ _ I _ _ Shower ___/ Dishwasher 1 Shower Pan
Drinking Fountain Slop Sink
Floor Drain _
Three C r3k:i �1 T;'
Floor Sink Toilet
Hose Bibs 1 Urinal _
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory ___Z______ Water Heater ___L_
Other Fixtures Water Treating System
MISCELLANEOUS:
❑ Sewer Replacement ❑ Back Flow Presenter ❑ Grease Interceptor (Trap) gallons (Requires 3 sets
❑ Lawn Sprinkler System Number of Beads ❑ Well * *
** SIRWD Well Completion Form. Completed form to be submitted to tine Building Department for final inspection. **
❑ Other -
_..1, .:._._ ° 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
.'; rpplication 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 does not give authority to violate the provisions of any other state or local law regulation consnvction or the performance of constrrcnon.
Property Owners Name i Z ff 4•00/ Al G Phone Number Z' .' I 900
Plumbing Company D vid Gray Plumbing, Inc.
g P Y // __ Office :. ho 7 ?�7 - Sfv �g
ls�I.Q a T'
Co. Address: � ct25 tV -- City' RP &5 t/vt`t f S : - •,� �t-, Zip 3 1 i
License Holder (Print): DRIP e G ' State Certification/Re- . ,ion # Clef eA2-5"86
Notarized Signature of License Holder PlAn4IZ
Sworn and subsasibei before we thi /14 day of 20 iy
"0 "0., Notary public State of Florida Signature of Notary? Public lagt
Neal R Major
;,` o` My Commission EE032510
'oi no Expires 12/20/2014