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Sewer 1941 43 Beach Ave 2011 :mgr °i CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 F3]T Application Number . . . . . 11-00002006 Date 4/28/11 Property Address . . . . . . 1941 43 BEACH AVE 1943 Application type description PLUMBING ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . 0 ---------------------------------------------------------------------------- Application desc Connect to Sanitary Sewer (2) 1941 and 1943 --------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ MORGAN, WILLIAM C.W. WOOD PLUMBING 220 EAST FORSYTH 1328 ROMNEY STREET JACKSONVILLE FL 32202 JACKSONVILLE FL 32211 (904) 744-6604 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc . . 2 SEWER CONN. 1941 AND 1943 Permit Fee . . . . 69 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 10/25/11 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . STATE PLBG DCA SURCHARGE 2 . 00 STATE PLBG DBPR SURCHARGE 2 . 00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 69 . 00 69 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 73 . 00 73 . 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 TA Ph 800 Seminole Rd Atlantic Beach, FL 32233 G Phz(904) 247-5826 Fax(904) 247-5845 JOB ADDRESS: /y� J �_! 13c'�,c 4 4f ` PERMIT# NEW OR REPLACEMENT INSTALLATION: Project Value $ 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 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 ** **SJR WD Well Completion Form. Completed form to be su mitted to the Building Dep ent for final inspection.** ❑ Other - c I L�} /V �2 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 �� �"��S_ �cvr �, Phone Number Plumbing Company �.�✓. l.-l/�vci/ /��U^►1�.-�c Office Phone �y`/-��-'`/ Fax 7y3 -�7✓c� Co. Address: 132-F City J uX State/ Zip3 2-2 License Holder(Print): G1e . State Certification/Registration f7 Notarized Si na (/ WHITE'S6 Y NA, MY COMMISSION DD63$*o and subscribed before e 's C--'0 day o � �-� 2VZ EXPIRES:May 21,201 -- '+r Pubo,Unde jars %tR•�yQ BondedThruNotary e of Notary Public ' G � - GIJ .� aU CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 ill), Application Number . . . . 11-00000490 Date 4/28/11 Property Address . . . 1941 43 BEACH AVE 1943 Application type description SYSTEM DEVELOPMENT CHARGE RESIDENTIAL (S Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc System charge for 2 taps 1941 and 1943 ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ MORGAN, WILLIAM OWNER 220 EAST FORSYTH JACKSONVILLE FL 32202 ---------------------------------------------------------------------------- Permit . . . . . . SYSTEM DEVELOPMENT CHARGE RES Additional desc . . SYSTEM DEV CHG 1941 AND 1943 Permit Fee . . . . 8100 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 4/28/11 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 8100 . 00 8100 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Grand Total 8100 . 00 8100 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES.