1035 Big Pine Key 2012 1 fixture move washer I
1t, CIT17 OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
12-00000795 Date 6/26/12
Application Number . 103 BIG PINE KEY
Property Address . . • • •
Application type description PLUMBING ONLY
Property Zoning . . . . . . . TO EE UPDATED
Application valuation . 0
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Application desc
1 fixture washer ----------------------------- --
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Owner Contractor
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CURLEE LINDA A PLUMBERS INC.
1035 BIG PINE KEY 8437 ALTON AVE.
ATLANTIC BEACH FL 322334363 (904)JACKSONVILLE
KSON IL 945
E FL 32211
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Permit . . . . . . PLUMBING PERMIT
Additional desc . Plan Check Fee . 00
Permit Fee . . . . 62 . 00 0
Issue Date Valuation
Expiration Date . . 12/23/12
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Other Fees
STATE PLBG DCA SURCHARGE 2 . 00
ST TE PLBG DBPR SURCHARGE 2 . 00
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Fee summary Charged Paid Credited Due
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- . 00 . 00
Permit Fee Total 62 . 00 62 . 00 . 00 . 00 4 . 00 . 00 . 00
Plan Check Total . 00
Other Fee Total 4 . 00 00 . 00
Grand Total 66 . 00 66 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALI, 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) 247-58 Fax 9 4) 247-5845
PERMIT #
JOB ADDRESS:
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub S ptic Tank&Pit
Clothes Washer S iower
Dishwasher ower Pan
Drinking Fountain lop Sink
Floor Drain hree Compartment Sink
Floor Sink oilet
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory ater Heater
Other Fixtures Water Treating System
RE-PIPE:
TYPE OF FIXTURE QTY YPE OF FIXTURE QTY
Bathtub eptic Tank&Pit
Clothes Washer hower
Dishwasher hower Pan
Drinking Fountain lop Sink
Floor Drainhree Compartment Sink
Floor Sink oilet
Hose Bibs rinal
Kitchen Sink acuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
MISCELLANEOUS:
❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease I terceptor (Trap) gallons(Requires 3 sets of plans)
❑ Lawn Sprinkler System-Number of Heads
❑ Well **
** SJR WD Well Completion Form. Completed form to be subn titted to the Building Department for final inspection.**
❑ Other
Permit becomes void if work does not commence within a six month period or wort.is suspended or abandoned for six months.1 hereby certify that 1 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 to violate the provisions of a4ny other stale or local law regulation construction or the performance of construction.
Property Owners Name Phone Number.
Plumbing Company .. � � Fax
701
Office Phone
Co. Address:
City State Zip
License Holder(Print):
St a Certific istration#C' G �����
Notarized Signature? License Holder
SHIRLEY L.Gw Ate+ d subscribed bef r m this (Py o 20
MY COMMISSION# 1
y•. ia.? EXPIRES:i=Pbruary 14,2014
"eP h�P Bonded Thru Notary Public of Notary Publi