539 Selva Lakes Cir 2012 repipe plumb ,�tij
is CI'T'Y OF ATLANTIC BEACH
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800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
it INSPECTION PHONE LINE 247-5814
Application Number 12-Ii00001081 Date 8/20/12
Property Address . . . . . . 539' SELVA LAKES CIR
Application type description PLU14BING ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . 0
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Application desc
repipe 16 fixtures
------ 1
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Owner �I!
Contractor
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------------------------
ALBRECHT, SUSAN E �I, WATSON PLUMBING
539 SELVA LAKES CIR 4456 SUNBEAM RD ## 200
ATLANTIC BEACH FL 322334361 N'' JACKSONVILLE FL 32257
(9 04) 889-6840
------------------------------- --
-- -- ------------------------------------
Permit PLUMBING PERM 'T
Additional desc
Permit Fee . . . . 167 . 00 Plan Check Fee . 00
Issue Date Valuation 0
Expiration Date 2/16/13
-------------------------------- _
Other Fees E PLBG DCA SURCHARGE 2 . 51
STAtE PLBG DBPR SURCHARGE 2 . 51
----------------------------------
Fee summary Charged r-,aid Credited Due
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-------------- ----------
------ ---------- ----------
Permit Fee Total 167 . 00 1167 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 5 . 02 5 . 02 . 00 . 00
Grand Total 172 . 02 '172 . 02 . 00 . 00
it
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PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF A ANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Bach, FL 32233
Ph (904) 247-5826 Fax (904) 247-5845
�.� sF� ��
Jos ADDRESS: .0 I ES C PERMIT
NEW OR REPLACEMENT INSTALLATION: Projecl Value $
TYPE OF FIXTURE QTY TY f E OF FIXTURE QTY
Bathtub Se tic Tank&Pit
Clothes Washer Sh wer
Dishwasher Sh wer Pan
Drinking Fountain Sl Sink
Floor Drain Th ee Compartment Sink
Floor Sink Toilet
Hose Bibs Urinal
Kitchen Sink Va uum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures Wa er Treating System
1ZE-PIPE:
i
TYPE OF FIXTURE QTY TYj�,E OF FIXTURE QTY
Bathtub o`�. Sep tc Tank& Pit
Clothes Washer �- Shower
Dishwasher ! Sh er Pan
Drinking Fountain Slo Sink
Floor Drain Thr e Compartment Sink
Floor Sink Toi'et
—
Hose Bibs Uri al
Kitchen Sink ! Va um Breakers
Laundry Tray WatNer Connected Appliances
Lavatory - - Wader Heater
Other Fixtures _ Wat�r Treating System p�
fVI j
t1ISCEI_-L * NFOUS:
Sewer Rep?accrnent ❑ Back Flow Preventer ❑ Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
Lawn Sprinkler System-Number of Heads ❑ NVell
k SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection."
Other
'ermit becomes void if work does not commence within a six month period or work is sus ended 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 ordinances governing this work will be complied with whether specified
>r not. The permit does not give authority to violate the provisions of any other state or to al law regulation construction or the performance of construction.
?roperty Owners Namerf�. rAlt.�' .C, 6-C hl7—" Phone Number S
d �✓
dumbing Company ,4 �.So ,of A,1Lli1�i�! Office Phone 7,T7- Wax r99' <f.Z 7
o. Address: 4I)-/.S i .2 f,,0 City�'I 'c �So cP�i-ate 4L Zip.-.-Z 2-4--/'
License Holder(Print): GJr..I to Certi rcation/Registration# CFG O,d-7.,1., S�
Votarized Signature of License Holder
WANDAY.GUESS S'v4)rn and subscribed before& this day of G- 20 JZ
;._ Commission#EE 07098: )
a Expires April 16,2015 Signature of Notary Public
Balled TMu Troy Fain Insm.ffiJ(M-7019