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Permit Plbg 1112 Fleet Landing 2012 tr m ) so CITY OF ATLANTIC BEACH l 800 SEMINOLE ROAD " � Z. ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5814 Application Number 12- 00000307 Date 3/26/12 Property Address 1112 FLEET LANDING BLVD Application type description RESIDENTIAL ALTERATION Property Zoning TO BE UPDATED Application valuation . . . 1900 Application desc shower conversion Owner Contractor NAVAL CONTINUING CARE NORTH RIVER BUILDING SOLUTIONS RETIREMENT FOUNDATION, INC 6771 SHINDLER DR 1 FLEET LANDING BLVD JACKSONVILLE FL 32222 ATLANTIC BEACH FL 322334599 (904) 838 -9179 - -- Structure Information 000 000 SHOWER CONVERSION Occupancy Type RESIDENTIAL Permit PLUMBING PERMIT Additional desc . Sub Contractor . ASHLEY PLUMBING CO INC Permit Fee . . . 69.00 Plan Check Fee . . .00 Issue Date . . . Valuation . . . . 0 Expiration Date . 9/22/12 Other Fees STATE PLBG DCA SURCHARGE 2.00 STATE PLBG DBPR SURCHARGE 2.00 Fee summary Charged Paid Credited Due Permit Fee Total 69.00 69.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.00 4.00 .00 .00 Grand Total 73.00 73.00 .00 .00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. PLUMBING PERMIT APPLICATION �(} ' k� 5N K� 7 CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach, FL 32233 Ph (904) 247 -5826 Fax (904) 247 -5845 JOB ADDRESS: 1 1 P. T vrwlkr4-1 ' .u- - PERMIT # /2 -3D 7 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 RE -PIPE: 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 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 final inspection. ** ❑ Other A 0- ( Ti.i 6 •M ,tie» -, Pp KJ s4.. -, pa,.' &p1k- -c 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 provisions of any other state or local law regulation construction or the performance of construction. Property Owners Name Feet .J t/�'"r -t a/_. Phone Number Plumbing Company Pkb\-■,,c • iv ,3 Office Phone Y i 3-175'7 Fax - - 05 - 5 - 2_ Co. Address: (II 1% 13e--,—) V-tl`� City ��� � � Cit State / Zip i? ti I � !' / � License Holder (Print): /'I> �� y l f' „ State Certification/Registration # .( o', `7 . 8c>'{ Notarized Signal '_ _ _. _..... — _ _:.... _ _ —4� � sy / r. Erb SHIRLEY L. GRA.' T .r *; - 1 MV COMMIS Q �9 506,0 SLbscrib aefo m e da Y a 20 12 , '•.�. -�a tXPIRES• a - p F oQ'" Bonded Thru Notary Public Underwriters I otary Pu,1ic 111 4 _ ■ 4