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.