Permit Plumbing Fixture 1652 Coquina Pl 2012 CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
J e ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number 12-00001405 Date 9/28/12
Property Address . . . . . . 1652 COQUINA PL
Application type description PLUMBING ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
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Application desc
1 fixture
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Owner Contractor
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KNIGHT AMELIA PLUMBING
2232 FLORIDA BLVD
ATLANTIC BEACH FL 32233 NEPTUNE BEACH FL 32266
(904) 821-8355
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Permit . . . . . . PLUMBING PERMIT
Additional desc . .
Permit Fee . . . . 62 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 3/27/13
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Other Fees . . . . . . . . . STATE PLBG DCA SURCHARGE 2 . 00
STATE PLBG DBPR SURCHARGE 2 . 00
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 62 . 00 62 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 66 . 00 66 . 00 . 00 . 00
PERMkT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILgING CODES.
I
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph (904) 247-5826 Fax (904) 247-5845
.TOB ADDRESS: I �5d� �U,4 ftol-) �I QC� PERMIT#
NEW OIR REPLACEMENT INSTALLATION: Project Value $
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub 1 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
MISCE LANEOUS:
Sewer ?,eplacement 0 Back Flow Preventer 0 Grease Interceptor(Trap) gallons(Requires 3 sets
of plans)
0 Lawn Sprinkler System-Number of Heads 0 Well
** SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.**
Other
Permit becorr es 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 rmit does not give authority to violat the provisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name 1 Phone Number 3n "f ag
Plumbing Company. Office Phone N4)"—N6 Fax2a_- 53�S_-
Co. Addr ss: r sk �t 3 City State Zip
License older(Print): State C ifi n/Registration#C':r O_o5 4-1
NotarizedSig atattq iw
_
NIV;^Onp AISSION#DD 957760
= :g= t MRCS.Februa d subscribed before e is d of 201
pF Fta Bonded:hru Notary Publ
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PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph (904) 247-5826 Fax (904) 247-5845
JOB ADDRESS: PERMIT #
Signature of Notary Public