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Permit 871 Sherry Dr 2012 plumb CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 irit Application Number . . . . . 12-00000311 Date 3/19/12 Property Address . . . . . . 871 SHERRY DR Application type description PLUMBING ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc 3 fixtures ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ PALMER-CHUNG ATLANTIC COAST PLUMBING CORP. 871 SHERRY DRIVE 3653 REGENT BLVD #305 ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32224 (904) 249-5381 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc . . Permit Fee . . . . 76 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 9/15/12 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . STATE PLBG DCA SURCHARGE 2 . 00 STATE PLBG DBPR SURCHARGE 2 . 00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 76 . 00 76 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 80 . 00 80 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. Mar 19 12 05: 57p Susan Parrish 904-246-3673 P. 1 PLUMBING PERMIT APPLICATION CITY OF ATLANTIC BEACH 900 Seminole Rd Atlantic Beach, FL 322333 Ph(904) 75826 Fax(904)247-5845 JOB ADDRESS: PERmrr# NEW 01 CEMM STALLATION: /Project Value S 0 QTY 7WE oF Fbrmxe gry Bathtub Septic Tank&Pit Clothes Washer Shower Dishwasher Shower Pan Drizibag Fountain Slop Sink Floor Drain TIrce Compartment Sink Floor Sink Toilet Rose Bibs Urinal Kitchea Sink Vacuum Breakers Laundly Tray Water Connected Appliances Lavato F7 Water Heater Other xxtures Water Treating System RE-PIPE: 7)w oF FvauRE QTY TFPEoFFmwRE QTY Bathtub Septic Tank&Pit Clothes Washer Shower Dishwasber Shower Pan Drimicing Fountain Slop Sink Floor Drain Three Compartment Sink Floor Simk Toilet Hose BiU Urinal Kitchen Sink Vacuum Breakers Laundry Tray Water Connected Appliaaces Lavatcy .y Water Heater Other Fbdures Water Treating System BUSCELLANEOUS: o Sewer Replacement 0 Back Flow Preventer o Grease Interceptor(Trap) gallons(Requires 3 sets of plans) 0 Lawn Sprinkler System-Number of Heads C1 Well **SJ)?WD Well Completion Form. Completed-f—omto be submitted to th—e—Biu-lid—ing Department for f inal inspection. JF Other Pemitbecomes void if work does notcommeace withk a six mooth'ya�,riok issa-spended orabandonedfor six mowlis.Ihm-cby ecrdfy ttat I have read this application and kmaw the sL=to be true and cwrect All provisioas of laws md ordinances goveming dils work wig be compiled with whadw spocified or rLot. The pcanit docs not give urdl?"ity to violate ffic pTovisicos of any od=r4m or local law regaMon consbucticla or the perfemance of coumuctiork. Property Owners Name N�u t-n 'N"/n Phone Number Plumbing Company /:;7,1�z ofacephone Co. Address: RIV city �17/9)( state lk�z_zip License Holder (Print): Wle"K ?19rri b;�p/Registration#AV e9 LO Notarked Signature of License RoMer Swom and subs"b before me this day of 20LZ DIANE 0.ROCNE & _ 7 Notary Public-Stale of Florida Signature of Motary Public MY COMM.Expires Apr 15,2013 COMMISSIOR#DD 112091a 10 n ftd T hr o u g h 119 D Om 2 1 N ON r Y A s s P.