Permit Remodel/Repairs 532 David St 2012 'S'''
:=4 . , r� CITY OF ATLANTIC BEACH
4-4 r) 800 SEMINOLE ROAD
''� r, q, r` ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
Application Number 12- 00000835 Date 7/19/12
Property Address 532 DAVID ST
Application type description RESIDENTIAL ALTERATION
Property Zoning TO BE UPDATED
Application valuation . . . 4280
Application desc
REMODEL BATHROOMS AND REPAIRS TO FRONT PORCH
Owner Contractor
LINDLEY THOMAS JACK ET AL KM CUSTOM BUILDERS, INC.
502 EDBURTON CT 2850 TUSCAROR TRAIL
HILLSBOROUGH NC 272789712 MIDDLEBURG FL 32068
(904) 298 -4607
- -- Structure Information 000 000 REMODEL BATHROOMS AND PORCH REPAIRS
Occupancy Type RESIDENTIAL
Permit PLUMBING PERMIT
Additional desc .
Sub Contractor . JERRY NOLAN PLUMBING INC
Permit Fee . . . 76.00 Plan Check Fee .00
Issue Date Valuation . . 0
Expiration Date . . 1/15/13
Special Notes and Comments
2010 FLORIDA BUILDING CODE, 2008 NATIONA1 ELECTRIC CODE
*REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING
DEPARTMENT IMMEDIATELY.
Other Fees STATE PLBG DCA SURCHARGE 2.00
STATE PLBG DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 76.00 76.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 80.00 80.00 .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: 3 ik t v c_.1 S1
p
PERMIT # /- Y3S
NEW OR REPLACEMENT INSTALLATION: Project Value $ -2 L ( 3 • °.
TYPE OF FIXTURE QTY TYPE OF FIXTURE
Bathtub QTY
Clothes Washer t Septic Tank & Pit
Dishwasher Shower
Drinking Fountain Shower Pan
Slop Sink
Floor Drain
Floor Sink Three Compartment Sink
Hose Bibs Toilet
/
Kitchen Sink Urinal
Laundry Tray Vacuum Breakers
Lavatory Water Connected Appliances
Other Fixtures Water Heater
Water Treating System
3
RE -PIPE:
TYPE OF FIXTURE QTY TYPE OF FIXTURE
QTY
Bathtub Septic Tank & Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three 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
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 to violate the provisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name Phone Number
Plumbing Company J r P (‘ ,,\ rt,,., i n . ,._t c Office Phone 7 7 L -- o 0 37 Fax `LI /- g.�y -4
Co. Address: P b • A- -1,t aliLif City cic“, kJvngi ( << State L
Zip-32.?2 j-
License Holder (Print): g crr7 cl - �a lc.% State Certification/Registration # 6F CO S ‘'9k
Notarized Signature of License Holder L. A
4 114 SHIRLEY L. G� A ►turn aid subscribed b 'ore
MY COMMISSION s< DD 957760 d • of or / 20 ,
toy e ` Bo ed n N ary P a 2014 of Notary Publi IA
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