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
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Application desc
3 fixtures
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Owner Contractor
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PALMER-CHUNG ATLANTIC COAST PLUMBING CORP.
871 SHERRY DRIVE 3653 REGENT BLVD #305
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32224
(904) 249-5381
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Permit . . . . . . PLUMBING PERMIT
Additional desc . .
Permit Fee . . . . 76 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 9/15/12
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Other Fees . . . . . . . . . STATE PLBG DCA SURCHARGE 2 . 00
STATE PLBG DBPR SURCHARGE 2 . 00
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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.