1855 Live Oak Ln plumb repipe 2012 CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
ATLANTIC BEACH FL 32233
� INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-00000763 Date 6/19/12
Property Address . . . . . . 1855 LIVE OAK LN
Application type description PLUMBING ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
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Application desc
15 fixtures
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Owner Contractor
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WYLIE TODD & SILET STEEG PLUMBING
1855 LIVE OAK LN 1601 MAIN STREET
ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233
(904) 249-5191
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Permit . . . . . . PLUMBING PERMIT
Additional desc . .
Permit Fee . . . . 160 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 12/16/12
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Other Fees . . . . . . . . . STATE PLBG DCA SURCHARGE 2 .40
STATE PLBG DBPR SURCHARGE 2 .40
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 160 . 00 160 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 80 4 . 80 . 00 . 00
Grand Total 164 . 80 164 . 80 . 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: � ��� Z1 V< Oise Y PERMTr#
NEW OR REPLACEMENT INSTALLATION: ]Project Value$
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
FDrinking SlopSink
loor Drain Fountain Thre 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:
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub 2_ Septic Tank&Pit
Clothes Washer / Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet 12
HoseBibs 7.- Urinal
Kitchen Sink /• _ Vacuum Breakers
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 plan
❑ Lawn Sprinkler System-Number of Heads ❑ Well **
X* 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 that I have r(
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 specifi(
or not. The permit does not give authoriV to violate the provisions of any other state or local law regulation construction or the performance of construction
Property Owners Name Jae Phone Number
Plumbing Company Alibv 6 G Office Phone t Fax
Co. Address:
r City Le State jol`/ ZiP744 3
License Molder(Print): -T M C State Certification/Registration# C'fi!�21
A17atariz ,.b ` � e Holder
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