Permit Mech 1 Fleet Landing O Bldg 2012 0 ,1"
F CITY OF ATLANTIC
BEACH
800 SEMINOLE ROAD
,,;� ,�.. ATLANTIC BEACH, FL 32233
J3
INSPECTION PHONE LINE 247 -5814
Application Number 12- 00000579
Property Address 1 FLEET LANDING BLVD MAINate 5/11/12
Tenant nbr, name 0 BLDG
Application type description PLUMBING ONLY
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
1 water heater
Owner Contractor
NAVAL CONTINUING CARE DAVID GRAY PLUMBING INC.
FLEET LANDING 6491 POWERS AVENUE
1 FLEET LANDING BOULEVARD JACKSONVILLE FL 32217
ATLANTIC BEACH FL 32233 (904) 724 -7211
Permit PLUMBING PERMIT
Additional desc .
Permit Fee . . . 62.00 Plan Check Fee .00
Issue Date Valuation 0
Expiration Date . . 11/07/12
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.
Mar 08 10 12:54p Information S
YstemsC ITY 0
90 4-247 -5845
PLUMBING PERMIT APPLICATION P.1
CITY OF ATLANTIC BE
800 Seminole Rd Atlantic Beach, FL 32233
Ph (904) 247 -5826 Fax (904) 247 -5845
JOB ADDRESS: / 1.E17 .1 i
/N 11Y � 49.. 3A. p a. PERK #
NEW OR REPLACEMENT INSTALLATION:
Project Value $
TYPE OF FIXTURE QTY
TYPE OF
Bathtub Qr ,�,
Clothes usher Shower Tank & Pit
Drinking Fountain Shower Pan
Floor Drain Slop Sink -----
Floor Sink Three Compartment Sink __ _ _
Hose Bibs Toilet - --
Kitchen Sink ----- Urinal —
Laundry
Tray Vacuum Breakers —
Water Connected Appliances
O ry
ther Fixtures ---- -- Water Hearer
Water Treating System L PS
RE -PIPE:
•
TYPE OFFIXTURE
Bathtub TYPE of Fs
Clothes Washer
Septic Tank & Pit
Dishwasher --- Shower - ----
Drinking Fountain Shower Pan —
Floor Drain :_ ...: Stop Sink
Floor Sink
Three Compartment Sink
Hose Bibs Toilet -----
Kitchen Sink - ---- -- Urinal - _.______
Laundry Trap Vacunrn Breakers ._
Lavatory
Water Connected A1�pIiauces1 _ _ Fleeter
1�'lJ[SCCELLAN — at ?r= ti S • e—i — _
SOUS:
o Sewer Replacement ❑ Back Flow Preventer 0 Grease Interceptor (Trap)
0 Lawn Sprinkler S-ystem Number of Heads — -- gatIons (Requires 3 sets of plans)
** SJRND Well Completion Form_ Completed fo m oo be submitted to the ni d'
0 Other ___ _ impartment f ®r final inspection.**
Permit becomes void if work does not commence ^ _
this mmen hi S3 a month
application b c ome and d if know the same to be true and wi .:t zi n 1 period or work is susp o r a bandoned r i c ..
this
or not. The permit does not All provisions of laws and t plied with whether that I have ed
e authority to violate the provisions of ondma la y r rap „„ ^a win be complied with whether specifi
any other state or local law r _ x_.: a cts. or the performance of construction.
Property Owners Name At—rely 441'IP /H4
Plumbing Contpar�y -3tvtt :. ray Plumbing, nc, Phone Number 7' gQ C`Id
Co, Address:' j �a12s' �-✓
Office Phone % � L--.S Fax ':,�- 5` 13
License Holder (Print): Me �;. City �i�dxv��� State Zip ZZ I'f
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Notarized Signature of License Holder Sate Certification/Registration ionlRegistration # G' it r' ,r
/ _
: Notary Puolic State of Florida orn 8 _ _ S13E]St`1 ibCd ore 123E this 2 Neal R Major d3 of �t/ 0 / My Commission EE032510 • gnaw e of Notary Publi / a/ - L_ xpires 1 2/20/2014 ��
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