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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 ---------------------------------------------------------------------------- Application desc 1 fixture ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ KNIGHT AMELIA PLUMBING 2232 FLORIDA BLVD ATLANTIC BEACH FL 32233 NEPTUNE BEACH FL 32266 (904) 821-8355 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc . . Permit Fee . . . . 62 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 3/27/13 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . STATE PLBG DCA SURCHARGE 2 . 00 STATE PLBG DBPR SURCHARGE 2 . 00 ---------------------------------------------------------------------------- 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 ��1 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