Permit Plbg Repipe 2143 Fairway Villas 2012 J�,
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CITY OF ATLANTIC BEACH
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; .r 800 SEMINOLE ROAD
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j :� ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
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Application Number 12- 00000500 Date 4/30/12
Property Address 2143 S FAIRWAY VILLAS LN
Application type description PLUMBING ONLY
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
14 fixtures
Owner Contractor
COATES CHRISTOPHER J CHRISTY FIRST COAST PLUMBING
2143 FAIRWAY LANE S 1651 MAYPORT RD
ATLANTIC BEACH FL 322334421 ATLANTIC BEACH FL 32233
(904) 247 -4419
Permit PLUMBING PERMIT
Additional desc .
Permit Fee . . . 153.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 10/27/12
Other Fees STATE PLBG DCA SURCHARGE 2.30
STATE PLBG DBPR SURCHARGE 2.30
Fee summary Charged Paid Credited Due
Permit Fee Total 153.00 153.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.60 4.60 .00 .00
Grand Total 157.60 157.60 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
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PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH _
800 Seminole Rd Atlantic Beach, FL 32233
Ph (904) 247 -5826 Fax (904) 247 -5845
JOB ADDRESS: ,0-,/ daai(w Yeao c7 aL(i(..�0 ' PERMIT #
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 1 Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet 3
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
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 �'o ,�� �(,,t?C <J Phone Number &5- $ `7"/
Plumbing Companyeh > *Z , in - 1651 Mayport Road Office Phone a47--4-467 q Fax �` C ' ,
Co. Address: 6) l� /f Atlantic Beach, FL 32233 C State Zip
License Holder (Print): it Jr, f1 . 1 i, , State C- j / ation/Registration # C�
Notarized Si: nature of License o der
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.�� ev��, JULIE YOUNG CHRISM 1 ' , worn an su fo re m this � y of ( ' 20 /c.- f., i ■ :.'i MY COMMISSION # DD 873293
EXPIRES. July 2013 ;
� or ,v " vr'` Bonded rnru Not tary Public �ic underwriters . ignature of Notary Public �
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