Permit Plbg 2 Wtr Htrs 2209 Alicia Ln 2012 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
� ATLANTIC BEACH, FL 32233
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,, 00,'s, INSPECTION PHONE LINE 247 -5814
Application Number 12- 00000575 Date 5/11/12
Property Address 2209 ALICIA LN
Application type description PLUMBING ONLY
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
2 water heaters
Owner Contractor
MARSHALL DUANE F & LYNN L. DAVID GRAY PLUMBING INC.
500 CHERRY POINT RD 6491 POWERS AVENUE
WOOLFORD MD 216771311 JACKSONVILLE FL 32217
(904) 724 -7211
Permit PLUMBING PERMIT
Additional desc .
Permit Fee . . . 69.00 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 69.00 69.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 73.00 73.00 .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 SystemsClTY 0 004-247 -5845 p.1
PLUNIBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph (904) 247 -5826 Fax (904) 247 -5845
JOB ADDRESS: .Z Q " / f g PERNErr #
NEW OR REPLACEMENT INSTALLATION: Project Value $ /7 7U
TYPE OF FIXTURE QTY TYPE' OFFIXTURE 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 ) e (e rt L
- Other Fixtures Water Treating System
RE-PIPE;
T PE of FIX Qrr TYPE OF FEE QTY
Bathtub Septic Tank & Pit
Clothes Washer Shower
Dishwasher Shower Pan
.... Slop Sink
Flor Drinking 1 Fountain Compartment Sink
Floor Sink Toilet
Hose Bibs Urinal
Kitchen Sink Vacuum. Bre *kers
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)
❑ Lang Sprinkler System Number of ❑ Well **
** S<TRWD Well Completion Forma. Completed form to be submitted to the Building Department for final inspection.**
❑ Other . .
?.omit becomes void if work does not comma . e within is ri .. d or ,•r .. � .... u , .,, ; :. f :. s d
.. .r-
commence within a six month period or work is suspended or abandoned for six months. I hereby certify that I have read
this ,plicarion 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 p any o er state or local law regulation construction or the performance of construcson
Property Owners Name PC-let14 Q, provisions ° Ctl� 4 1 / Phone Number .6 2.-6 -" I � � 7
Plumbing Company Oavi 'Grey Plumbing, Inc Office Phon 1 *F 72 Fax 7 �5 S
8850 Uoj x /Tare Square Court
Co. Address: �.- ^���� City State Zip
License Holder (Print): Z7VJP . & €i9-x1 State CertifcationfRegistration_ # ere O - 6
1
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, ,` *`^, Neal R Major to of Florida worn and subscribed before me d day o 20 (J/
1c 4 My Commission EE032510
or op* Expires 12/20/2014 signature of Notary Public
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