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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 • 144'1%---9E-------------- ' �> ,� ` (_ �� 9f�rh `'� ■i3 PI RE Nobly P 20 7349 e2i t o J and subscribed befo - " is / ' owed _ day 20 ture of Notary Public / . / � / / �� a)