5212 Fleet landing Blvd 2012 shower conversion ClY OF ATLANTIC BEACH
1 s) 800 SEMINOLE ROAD
ATLANTIC BEACH FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12- 00000766 Date 6/21/12
Property Address . . . . . . 5212 ANTARES CT
Application type description RESIDENTIAL ALTERATION
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 2375
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Application desc
shower conversion
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Owner Contractor
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NAVAL CONTINUING CARE NORTH RIVER BUILDING SOLUTIONS
RETIREMENT FOUNDATION, INC 6771 SHINDLER DR
1 FLEET LANDING BLVD JACKSONVILLE FL 32222
ATLANTIC BEACH FL 322334599 (904) 838-9179
--- Structure Information 000 000 SH ER CONVERSION
Occupancy Type . . . . . . RESIDENTIAL
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Permit . . . . . . PLUMBING PERMIT
Additional desc . .
Sub Contractor . . ASHLEY PLUMBING CO INC
Permit Fee . . . . 69 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 12/18/12
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Other Fees . . . . . . . . . STATE PLBG DCA SURCHARGE 2 . 00
STATE PLBG DBPR SURCHARGE 2 . 00
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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.
PLUMBING PERMIT'iAPPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic , each, FL 32233
Ph (904) 247-5826 Fax ( 04) 247-5845
JOB ADDRESS: Z\2— �� PERMIT
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub ptic Tank& Pit
Clothes Washer S iower
Dishwasher S iower Pan
Drinking Fountain S op Sink
Floor Drain ree Compartment Sink
Floor Sink ilet
Hose Bibs inal
Kitchen Sink cuum Breakers
Laundry Tray ater Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
RE-PIPE:
TYPE OF FIXTURE QTY T rPE OF FIXTURE QTY
Bathtub Septic Tank&Pit
Clothes Washer St iower
Dishwasher S1 ower Pan
Drinking Fountain SI)p Sink
Floor Drain T1 ree Compartment Sink
Floor Sink Toilet
Hose Bibs U inal
Kitchen Sink V cuum Breakers
Laundry Tray ter 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)
❑ Lawn Sprinkler System-Number of Heads ❑ Well
** 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 read
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 specified
or not. The permit does not give authority t violate the provisions of any other state or ocal law regulation construction or the performance of construction.
Property Owners Name L",� I, Phone Number
Plumbing Company Office Phone Fax 15'90S5
Co. Address: ( 171 0o �-
City���C State f� Zip 'L-L
License Holder(Print): t, State Certification/Registration
Notarized Signature of Lic
ld
SHIRLEY L GRAHAM
r; a te ruary e is y Of 20
Bended Thru Notary Public Underwriters
b is