Permit Plbg Repipe 1276 Main 2012 0-L = '1 r
1�' CITY OF ATLANTIC BEACH
s) 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
�JJ INSPECTION PHONE LINE 247 -5814
Application Number 12- 00000515
Property Address Date 5/01/12
MAIN ST
Application type description PLUMBING ONLY
Property Zoning
Application valuation , TO BE UPDATED
• 2400
Application desc
Repipe 11 fixtures
Owner
Contractor
DOANER STEVEN B & SANDRA A
1276 MAIN STREET ST JOHNS PLUMBING
2260 MARLEE ROAD S
ATLANTIC BEACH
FL 32233 ST JOHNS
(904) 705 -5133 FL 32259
Permit PLUMBING PERMIT
Additional desc . 11 FIXTURES
Permit Fee 132.00
Issue Date . , . Plan Check Fee .00
Valuation 0
Expiration Date
10/28/12
Other Fees STATE PLBG DCA SURCHARGE
STATE PLBG DBPR SURCHARGE 2.00
2.00
Fee summary Charged Paid
Credited Due
Permit Fee Total 132.00
Plan Check Total 132.00 .00 .00
Other Fee Total �00 .00 .00
4.00 4.00 .00
Grand Total 136.00 .00 .00
136.00 .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
/ Ph (904) 247 -5826 Fax (904) 247 -5845
JOB ADDRESS: /2 7 41 , �� (
���� PERMIT # J7
NEW OR REPLACEMENT INSTALLATION: Project Value $
TYPE OF FIXTURE QTY TYPE OF FIXTURE
Bathtub QTY
Clothes Washer Septic Tank & Pit
Dishwasher Shower
Drinking Fountain Shower Pan
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 1 QTY
Clothes Washer i Septic Tank & Pit
Dishwasher er
Drinking Fountain Shower Pan
Floor Drain Slop Sink j
Floor Sink Three Compartment Sink
Toilet 1. Hose Bibs
A., Urinal
Kitchen Sink I Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory -1-- Water Heater 1
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 certi 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 t ovisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name ST U Q %�Q4L--
J ,,1 Phone Number 11/ 01
Plumbing Company JT G O PI f (All a t./ -+
Office Phone 2/ i- Z° ` i i Fax
Co. Address: 16 b RrL4.t f h f
City State Zip
License Ho "�- - � Rv � e.rt Cr- IA ► fo t� _ Oral'
State Certification/Registration # CrC f
Notarized •
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