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Permit Plbg 150 Sherry Dr 2012 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD W"hit ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 12-00000747 Date 6/13/12 Property Address . . . . . . 150 SHERRY DR Application type description PLUMBING ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc 2 fixtures ------------------------------------------------------------------------ Owner Contractor ------------------------ ------ ---------------- COMMUNITY PRESBYTERIAN F.W. FAIR PLUMBING CO. CHURCH P.O. DRAWER 51558 150 SHERRY DR JAX BEACH FL 32250 ' ATLANTIC BEACH FL 32233S236 (904) 241-7191 ---------------------------------------------------------------------------- Permit PLUMBING PERMIT jAdditional desc . . Permit Fee . . . . 69 . 00 Plan Check Fee . 00 ' Issue Date . . . . Valuation . . . . 0 � Expiration Date - - 12/10/12 ----------------------------------------------------------------------- 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 I 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. PLUMBING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach, FL 32233 Ph (904) 247-5826 Fax (904) 247-5845 JOB ADDRESS: PERMIT# NEW ORR, EPLACEMENT 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: i 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 kL.T ose Bibs Urinal itchen Sink Vacuum Breakers Laundry Tray Water Connected Appliances Lavatory Water Heater Other Fixtures Water Treating System MISCEL LANEOUS: 0 Sewer Re lacement El Back Flow Preventer Ei Grease Interceptor (Trap) P _gallons(Requires 3 sets of plans) El Lawn Sprinkler System-Number of Heads El Well SJR WD 'Well Completion Form. Completed—form to be submitted to the Building Department for final inspection. 0 Other — 1 Permit becomO void if work does not commence within a six month period or work is suspended or abandoned-for six months—1hereby certify-that I have read this application Od know the same to be true and correct. All provisions of laws and ordinances governing this work will be co*mplied with whether specified or not. The periinit does not give authority to violate the provisions of any other state or local @]a v regulatiop con�truction or the performance of construction. Property Owners Name 040/4one Number Plumbing Company 1A �X J�b Office Phone J f(Tax 2� y,/ -Zva-T Co. Address': city State Zip License Holder (Print): ertification/Registration# Notarized Signature of License Holder SHIRLEY1 an subscribed beLofe m this -A 20 --*S MY COMMISSI(5N M09571 f EXPIRES:Feb uAl Bon*d'ed Thru Notary'p Notary Pu�iic 11f 11.............