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1846 Selva Grande 2012 water heater f�a CIT OF ATLANTIC BEACH 800 SEMINOLE ROAD r� ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 12- 0000773 Date 6/21/12 Property Address . . . . . . 184 SELVA GRANDE DR Application type description PL BING ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 --------------------------------------- -------- Application desc 1 water heater --------------------------------------- ---- Owner Contractor - ------------------------ ----------------------- JOHANNSEN, ERIK ROTO ROOTER SERVICES 1846 SELVA GRANDE DR. 2028 W 21ST ST ATLANTIC BEACH FL 322334526 JACKSONVILLE FL 32203 (904) 354-7321 --------------------------------------- --------- Permit PLUMBING PERMET Additional desc . . Permit Fee 62 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 12/18/12 ----------------------------------------------------- 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. V I�k �,GO41 PLUMBING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic BesEtch, FL 32233 Ph(904) 247-5826 Fax(90 4) 247-5845 JOB ADDRESS: 2 PEPMT# NEW OR REPLACEMENT INSTALLATION: Projecl Value $ 4r11. 00 TYPE of FIXTURE QTYT E OF FIXTURE QTY Bathtub Se tic Tank&Pit Clothes Washer Sh wer Dishwasher Sh wer Pan Drinking Fountain Slop Sink Floor Drain T1 ree Compartment Sink Floor Sink Tc'let Hose Bibs Ui'nal Kitchen Sink Vacuum Breakers Laundry Tray W Etter Connected Appliances Lavatory ter Heater — —eke C Other Fixtures W Etter Treating System RE-PIPE: TYPE OF FIXTURE QTY T PE OF FIXTURE QTY Bathtub S ptic Tank&Pit Clothes Washer Sl iower Dishwasher Sl iower Pan Drinking Fountain S p Sink Floor Drain T iree Compartment Sink Floor Sink T ilet Hose Bibs U rinal Kitchen Sink VEtcuum Breakers Laundry Tray Water Connected Appliances Lavatory Water Heater Other Fixtures Water Treating System MISCELLANEOUS: ❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Int rceptor (Trap) gallons(Requires 3 sets of plans) ❑ Lawn Sprinkler System-Number of Heads El Well ** ** SJRWD Well Completion Form. Completed form to be submi ed to the Building Department for final inspection.** ❑ Other Permit becomes void if work does not commence within a six month period or work i suspended or abandoned for six months.I hereby certify that I have read this application and know the same to be true and correct. All provisions of laws andordinances governing this work will be complied with whether specified or not. The permit does not give authority to violate the provisions of any other state er local law regulation construction or the pe f rm�ance of construction. Property Owners Name Phone Number Z&R,36A'3 q Olk C04 Plumbing Company - Re_,Ok�trOffice Phone Z54-rlZt Fax Co. Address: City e State VA-_Zip . n License Holder(Print): R,R pa 2 t 1;7A R State Certification/Registration# CVC- 6 N l39 Notarized Signature of License Holder v- 1 safURAA,ADAMS Sworn and subscribed beford me this otlsl day of 201%°, .. W COMMISSION N EE 179625 Ps� p 8ondedTMuNotary PobFcUnderwriters Signature of Notary Public �- 06/21/2012 08:38 9043549255 ROTOROOTER PAGE 62162 Z(3 04 PLUMBING PERMIT APePLICA.TION 3(\o'c Vr i CITY OF ATLANTI BEACH 800 Seminole Rd Atlantic Beach, FTS 32233 Ph,(904) 247-5826 Fw,,(90d)247-5845 JOB ADDRESS: e. '�N PERMED# NEW OR REPLACEMENT INSTALLATION: Project Values 'jryl.. b(Z^ TYPE OF FiXrm QTY TY E OF FIXTURE QTY Bathtub Se io Tank&Pit Clothes Washer Sh wer Disbwasher Sbc wer Pan Drinking Fountain Slo ) Sink Floor Drain T e Cornpar -nent Sink floor Sink To' et Hose Bibs Ur'lal Kitchein Si.t* Va-,uum Breakers Laundry Tray W 'er Connected Appliarizes Lavatory Wi ter Heater Other Fixtures Wi ter Treating System RE-PIPE: TXpE OF FxXTURF Q.'ry T E OF FIXTUR.F, QTY Bathtub Se tic Tar)k&Pit Clothes Washer Sh wer Dishwasher Shower Pan Drinking Fountain SIC p Slunk Floor Drain Tb.cc Compartment Sink Floor Sink To let Hose Bibs Ur nal Kitchen Sink V uum Breakers Laundry Tray _-- Water Connected Appliances Lavatory _ Wj ter Reater Other Fixtures Water Treating System ViISCELLANEOUS: :i Sewer Replacement ❑ Back Flow Preventer ❑ Grease Irate. eptor(Trap) gallons(Requires 3 sets of plum) :i Lawn Sprinkler System-Number of Heads r_l Well ** k*SIR WD Well Completion Form. Completed form.to be submitt d to the Building Department for fmal inspeotion.** Other 'erndt becomes void if work does not commence withitt 9,six month period or worse is, spended or abandoned for six months.I hereby certify that I have read his application and know the same to be true and correct. All provisions of laws and or Jinances governing this work will be complied with whether specified it not. The perrni.t does not give authority to violate the provisions of any other state or local law regulation construction or the performance of consiruction. ?roperiy Owners Name tri r_ !AZ3§23SC&J Phone Numberg A- ------ q 04 " ?Iumbbig Company ec Ofilice Phone �S' :�3 _Fax `f..a` - �o. Address: W_asi SA fl Cityw cn ty L�� State�Zip 3 Dq 'ieense Holder(Print.): 'Ir State Certi r cati.on/Registration# GV C. NS m�3 Votari ed Signature of`License 11older �.. BAF18Al1AA.ADAMS Sword and subscribed before i ae this_ day of 1�\s+tee„ .._. 201 w� MY COMMISSION t EE 179625 , , sOw6d ft WNY hbk ;�b,� Signature of Notary Public