Permit Plbg shower pan 2019 Beach 2012 J CITY OF ATLANTIC BEACH
J k ) 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
Application Number 12- 00000483 Date 4/25/12
Property Address 2019 BEACH AVE
Application type description PLUMBING ONLY
Property Zoning RES SF DISTRICT
Application valuation . . . 0
Application desc
REPLACE SHOWER PAN
Owner Contractor
HARKLEROAD CARL E PLUMB -PAL, INC.
2019 BEACH AVE 1728 SABLE PALM LANE
ATLANTIC BEACH FL 322335934 JAX BEACH FL 32250
(904) 246 -8856
Permit PLUMBING PERMIT
Additional desc . REPLACE SHOWER PAN
Permit Fee . . . 62.00 Plan Check Fee .00
Issue Date Valuation . . . . 0
Expiration Date . . 10/22/12
Other Fees STATE PLBG DCA SURCHARGE 2.00
STATE PLBG DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 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.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233 3
Ph (904) 247 -5826 Fax (904) 247 -5845
JOB ADDRESS: Zcp / ' 3- C t4,'./-
PERMIT #
NEW OR REPLACEMENT INSTALLATION: Project Value $
TYPE OF FIXTURE QTY TYPE OF FIXTURE
Bathtub QTY
Clothes Washer Septic Tank & Pit
Shower
Dishwasher
Shower Pan
Drinking Fountain
Floor Drain Slop Sink
Floor Sink Three Compartment Sink
Hose Bibs Toilet
Kitchen Sink Urinal
Laundry Tray Vacuum Breakers
Lavatory Water Connected Appliances
Other Fixtures Water Heater
Water Treating System
RE -PIPE:
TYPE OF FIXTURE QTY TYPE OF FIXTURE
Bathtub QTY
Clothes Washer Septic Tank & Pit
Dishwasher Showe
Pan Pa
Drinking Fountain
Floor Drain Sop Smk
Floor Sink Three Compartment Sink
Hose Bibs Toilet
Kitchen Sink Urinal
Laundry Tray Vacuum Breakers
Lavatory Water Connected Appliances
Other Fixtures Water Heater
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. Comple form to be su ed to the Building Department for final inspection. **
Il
II
— 1 -1-- - �� — G SA.
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. M 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 j�� s
c ' ( 2 t ' ) " 1 ae (, mac.., r Phone Number
Plumbing Company /3(....4, L , 10„(
Office Phone ? K.- & �' Fax
Co. Address: /7 7 S S 4 '13(sr f ft ( 4Z /- City J� j S tate F Zip Cit � f( - p _
License Holder (Print): /4 ,` <(
.� � State Certification /Registration # L FC 6 57 7,�
Nota . *% 7 a, T;Tr • r�H• der
1 „ ; " ' MY COMM
oi issiot # EE 057349 _ f
EXPIRES: 21, 8016 '
goaded Nu Notary May21,20i rwtirere worn and ubscribed bed', e this da of / 20 Z f
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Signature of Notary Publ i 4