Permit Plbg Repipe 1745 Beach 2012 f CITY OF ATLANTIC BEACH
s) 800 SEMINOLE ROAD
\\,,,,_. , ATLANTIC BEACH, FL 32233
,. INSPECTION PHONE LINE 247 -5814
J 9
Application Number 12- 00000445 Date 4/17/12
Property Address 1745 BEACH AVE
Application type description PLUMBING ONLY
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
9 fixtures
Owner Contractor
EAKIN, PAUL STEEG PLUMBING
1745 BEACH AVENUE 1601 MAIN STREET
ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233
(904) 249 -5191
Permit PLUMBING PERMIT
Additional desc .
Permit Fee . . . 118.00 Plan Check Fee .00
Issue Date Valuation 0
Expiration Date . . 10/14/12
Other Fees STATE PLBG DCA SURCHARGE 2.00
STATE PLBG DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 118.00 118.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 122.00 122.00 .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
806 Seminole Rd Atlantic Beach, FL 32233
Ph (904) 247 -5826 Fax (904) 247 -5845
JOB ADDRESS: /7 Y 1/2-0 PERMIT #
NEW OR REPLACEMENT INSTALLATION: Project Value
TYPE OF FIXTURE OTY TYPE OF FIXTURE OTY
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 OTY TYPE OF FIXTURE OTY
Bathtub / Septic Tank & Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain SIop Sink _
Floor Drain Three Compartment Sink
Floor Sink Toilet A
Hose Bibs _ Z Urinal
Kitchen Sink ! Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory g Water Heater /
Other Fixtures Water Treating System
•
MISCE
❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor (Trap) gallons (Requires 3 sets of pt:
❑ Lawn Sprinkler System - Number of Heads ❑ Well **
** SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspectioi
❑ Other
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
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 speci
or not. The permit does not give author to violate the provisions of any other state or Iocal law regulation construction or the performance of construct,
Property Owners Name / (r/ Pdx-Xhi _ )
Phone Number
Plumbing Company /f�i �„t1 ,t,c Office Phone (9 1 .11-57q/ Fax Y/ f?i
Co. Address: )( i 014 j 51 City i 4i• ,II State ,5 - ZiP3A
License Holder (Print): .1;* y t S12c: State Certification/Registration # gRD32 /94i
Notarized Signature o , - -.: - 4 =' -- _._. ��L
<�n? 114;; _ SHIRL / . ' ` y `
-` Ex - , 'l.i - etir -, e bed bef• - j fi -Y o &i.4 /'.
,p,' , ,.• Bonded Thru Notary Public Underwriters 1: /
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