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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 ---------------------------- Application desc 1 fixture washer ----------------------------- -- -- -- ----------------------------- Owner Contractor ------------- -------------- ---------- CURLEE LINDA A PLUMBERS INC. 1035 BIG PINE KEY 8437 ALTON AVE. ATLANTIC BEACH FL 322334363 (904)JACKSONVILLE KSON IL 945 E FL 32211 ------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc . Plan Check Fee . 00 Permit Fee . . . . 62 . 00 0 Issue Date Valuation Expiration Date . . 12/23/12 ___ --- --------------- -------- Other Fees STATE PLBG DCA SURCHARGE 2 . 00 ST TE PLBG DBPR SURCHARGE 2 . 00 _____ _ ______ ------- Fee summary Charged Paid Credited Due _ _----- ---------- -- ------- - - . 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