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763 Atlantic Blvd Unit c plumb TIC BEACH KP CIT' OF ATLAN 800 SEMINOLE ROAD '� s) ATLANTIC BEACH,FL 32233 I � INSPECTION PHONE LINE 247-5814 Application Number . . . . . 12- 0001093 Date 8/22/12 Property Address . . . . . . 763ATLANTICBLVD Tenant nbr, name . . . . . . UNIT C Application type description PL IBING ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 --------------------------------------- ----- Application desc 5 fixtures --------------------------------------- ------ Owner Contractor ------------------------ ------------------------ HANDLER FAMILY PARTNERSHIP DARLEYS PLUMBING INC. 65 S COLORADO BLVD 4472 PHILLIPS HIGHWAY DENVER CO 80246104 JACKSONVILLE FL 32207 (904) 727-1484 -----Permit . . . PLUMBING PERM T Additional desc . . Permit Fee 90 . 00 Plan Check Fee . 00 Issue Date . . . Valuation 0 Expiration Date . . 2/18/13 ------------------------------------------------------ Other Fees . . . . . . . . . STATE PLBG DCA SURCHARGE 2 . 00 STATE PLBG DBPR SURCHARGE 2 . 00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due -- ------ ---------- ---------- Permit Fee Total 90 . 00 90 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 94 . 00 94 . 00 . 00 . 00 I PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY 01 ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. it PLUMBING PERMIT PPLICATION CITY OF ATLANTI C BEACH 800 Seminole Rd Atlantic B'' ach, FL 32233 - Ph(904) 247-5826 Fax(9 4) 247-5845 / .TOB ADDRESS: AT' '�-'' � t7 e— vi"_ C PERMIT# I NEW OR REPLACEMENT INSTALLATION: Proje t Value $ TYPE OF FIXTURE QTY T PE OF FIXTURE QTY Bathtub S ptic Tank&Pit Clothes Washer S iower Dishwasher S iower Pan Drinking Fountain I S op Sink Floor Drain Tree Compartment Sink Floor Sink T ilet I Hose Bibs Urinal Kitchen Sink Vacuum Breakers Laundry Tray �— Water Connected Appliances Lavatory Water Heater 1 Other Fixtures V later Treating System RE-PIPE: TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY Bathtub S ptic Tank&Pit Clothes Washer S hower Dishwasher Shower Pan Drinking Fountain Sop Sink Floor Drain J hree Compartment Sink Floor Sink I oilet Hose Bibs rinal Kitchen Sink acuum Breakers Laundry Tray Water Connected Appliances LavatoryVater Heater Other Fixtures N Vater Treating System MISCELLANEOUS: ❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Int rceptor(Trap) gallons(Requires 3 sets of plans) i ❑ Lawn Sprinkler System-Number of Heads F,i Well ** ** SJRWD Well Completlon Form. Completed form to be submi ted to the Building Department for final inspection.** I i.-_1 Other Permit becomes void if work does not commence within a six month period or work i suspended or abandoned for six months.t 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 r local law regulation construction or the performance of construction. s Property Owners Name 144JA LAjt. F.o�`u i� �w N" I Phone Number(90y)3-?q–700 Plumbing Company r v Office Phone 717-I Yd y Fax-7 1OF 7 Co. Address: `/ //, City Us,.Uvh, I (c State F I ZipS U:, O7 License Holder(Print): Gn fir State Certification/Registration# C F G QSG 70.7 #"e Holder comm*DMM192 • Sworn and subscribed before m this day of 20 ID WWI� E)#rw a aM12 • Fbrde NotrAm.Ina • Signature of Notary Public tiuq��n���uunnn�u�u I I __