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Permit Plumbing 1163 Beach Ave 2012 CITY OF ATLANTIC BEACH 1j 800 SEMINOLE ROAD J ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 12-00000490 Date 10/18/12 Property Address . . . . . . 1163 BEACH AVE Application type description RESIDENTIAL ADDITION Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc 2nd story addition and remodel ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ ADAMS CHARLES P WORSHAM CONSTRUCTION CO INC 1163 BEACH AVE 2329 URBAN RD ATLANTIC BEACH FL 322335727 JACKSONVILLE FL 32210 (904) 545-2357 --- Structure Information 000 000 ADDITION 452 SF AND REMODEL Construction Type . . . . . TYPE 5-B Occupancy Type . . . . . . RESIDENTIAL Flood Zone . . . . . . . . ZONE AO ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc 21 FIXTURES AND REPLACE SEWER Sub Contractor CRABTREE PLUMBING INC Permit Fee . . . . 209 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 4/16/13 ----------------------------------------------------------------------------- Special Notes and Comments 2010 FLORIDA BUILDING CODE, 2008 NATIONAL ELECTRIC CODE *SUBMIT "CERTIFICATE OF COMPLIANCE" BY A LICENSED PEST CONTROL COMPANY PRIOR TO C.O. *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. WINDOW AND DOOR INSPECTION: *INSTALLATION INSTUCTIONS REQUIRED *ALL STICKERS ARE TO REMAIN ON THE WINDOWS *PROVIDE ACCESS TO ALL WINDOWS TO INSPECT FASTENERS Roll off container company must be on City approved list and container cannot be placed on City right-of-way. Contact Public Works (247-5834) for Erosion and Sediment Control Inspection prior to start of construction. Roll off container company must be on City approved list and container cannot be placed on City right-of-way. Contact Public Works (247-5834) for Erosion and Sediment Control Inspection prior to start of work'. ---------------------------------------------------------------------------- PERMIT Qt1Te1rOe6695LY IN ACCORDANCE XVITH THE FLORI)A 14 BUILDING CODES. CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 Page 2 Application Number . . . . . 12-00000490 Date 10/18/12 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . STATE PLBG DBPR SURCHARGE 3 . 14 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 209 . 00 209 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 6 . 28 6 . 28 . 00 . 00 Grand Total 215 . 28 215 . 28 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE, WITH ALI, CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. PLUMBING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach, FL 32233 Ph (904) 247-5826 Fax (904) 247-5845 JOB ADDRESS: f'/(, Qecoc..1 4(.•v— PERMIT# 12-,- S'9() NEW OR REPLACEMENT INSTALLATION: Project Value $la, cn.au TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY Bathtub 2 Septic Tank& Pit Clothes Washer Shower Dishwasher t Shower Pan Drinking Fountain Slop Sink Floor Drain Three Compartment Sink Floor Sink Toilet _ Hose Bibs Z 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 lJ , Lavatory Water Heater (/ Other Fixtures Water Treating System MISCELLANEOUS: 27i fewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor(Trap) gallons(Requires 3 sets of plans) ❑ Lawn Sprinkler System-Number of Heads ❑ Well ** SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.** ❑ Other 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 egoa'o• 1' Phone Number Plumbing Company Office Phone Fax 3' 9,/YS Co. Address: 23 V v((0,q . F2. city State ti State C-.-e—Zip &'Le 0 License Holder(Print): State Certification/Registration 9 ore asTzti�— Notarized Si natur dere:' [00!L : DEBORAH AMANDA WHITE MYCAMMISSION#EE057349 w r u scribed before this day of 20_z�EXPIRES:May 21,2015 �� ' 13,dedThruNotia�ypwkUrAetw�l ignature of Notary Public