Permit Plbg Water Softener 1792 Sea oats 2012 ` — olAkriel
", xi CITY OF ATLANTIC BEACH
iv
L. J 800 SEMINOLE ROAD
' ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
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Application Number 12- 00000493 Date 4/27/12
Property Address 1792 SEA OATS DR
Application type description PLUMBING ONLY
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
1 FIXTURE WATER SOFTNER
Owner Contractor
BOLTON, MARGARET R ATLANTIC COAST PLUMBING CORP.
1792 SEA OATS DR 3653 REGENT BLVD #305
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32224
(904) 249 -5381
Permit PLUMBING PERMIT
Additional desc .
Permit Fee . . . 62.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 10/24/12
Other Fees STATE PLBG DCA SURCHARGE 2.00
STATE PLBG DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 62.00 62.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 66.00 66.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
Apr 27 12 12: 18p Susan Parrish 904 - 246 - 3673 p•
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
g00 Seminole Rd Atlantic Beach, FL 32233
Ph (904) 247-5826 Fax (904) 247 -5845
JOB ADDRESS: j ft 5 A 0/91 L' PERMIT #
NEW R REPLACEMENT INSTALLATION: Project Value $ j 500 - 00
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank & Pit
Clothes Washer Shower
Dishwasher Shower Pan
Slop Sink
Floor
Drinking 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 ,-,./ / 0 �+ /e/Z—
RE -PIPE:
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank & Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
FIoor 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 0 Back Flow Preventer o Grease Interceptor (Trap) gallons (Requires 3 sets of plans)
D Lawn Sprinkler System- Number of Heads 0 Well **
** SJR WD Well Completion Form. Completed form to be submitted to the Building Department for final inspection. **
0 Other
Permit becomes void if work does not commence within a six uronth period or work is suspended or abandoned for six months.1 hereby certify that I have read
this application and ]mow 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 1^cA /3o /40 l'3 Phone Number x1''0 0244
Plumbing Company 4- i /A,v1-� �s
i/ 7 / 'd?, to/ Oface Phone 9,1.3.` ?( Fax ,5 9341
Co. Address: ga 7 ,Q /✓cI lfb g o.5' 1 City J/ 7X State L Zip 32 Z
License Holder (Print): ff o f, -�� ' _ S Certification/Registration # e-- 137 - 4) 4. 5-'05' ' c- '
Notarized Signature of License Holder d' C{,llif
-- - - - 10' worn and ubscribed before me thi day o Ar ./ 20L f
14 %. DIANE 0. ROCHE
•
r � ? Notary Public - State of Ftordda Signature of Notary Public cf. -
v. lily Comm. Expires Apr 15, 2013
Ctxntniaalon • DD 180918
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