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487 Selva Lakes Cir 2012 repipe CITY OF ATLANTIC BEACH J 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 12-00001613 Date 10/31/12 Property Address . . . . . . 487 SELVA LAKES CIR Application type description PLUMBING ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 -------------------------------------------- Application desc 10 Fixtures -------------------------------------------- Owner Contractor - ------------------------ ----------------------- CHARLES, CYNTHIA TRUST STEEG PLUMBING 487 SELVA LAKES CIRCLE 1601 MAIN STREET ATLANTIC BEACH FL 322334355 ATLANTIC BEACH FL 32233 (904) 249-5191 ----------------- Permit . . . . . . PLUMBING PERMIT Additional desc . . REPLACE FIXTURES . 00 Permit Fee 125 . 00 Plan Check Fee . Issue Date . . . Valuation 0 Expiration Date . . 4/29/13 --------------------- ----------------------------- Other Fees . . . . . . . . . STATE PLBG DCA SURCHARGE 2 . 00 STATE PLBG DBPR SURCHARGE 2 . 00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----- ---------- - Permit Fee Total 125 . 00 125 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 129 . 00 129 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. PLUMBIN O PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach.FL 32233 Ph(904) 247-5826 Fax(904) 247-5845 JO13 ADDRESS: y� �� �` �ia/ct l� PERM T# h/pf NEIN OR REPLACEMENT INSTALLATION: Project Value$ TYPE OF FIXTURE 07T TYPE of FixxTURE QTY Bathtub Septic Tank&Pit Clothes Washer Shower Dishwasher Shower Pan Drinking Fountain Slop Sink Floor Drava 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 FDCFURE Q7Y TYPE OFFL UVRE QTY Bathtub Septic Tank&Pit Clothes Washer �_ Shower Dishwasher Shower Pan FDrinking SlopSink loor Drain Thre Compartment Sink Floor Sink Toilet Z Hose Bibs Urinal Kitchen Sink Vacuum.Breakers Laundry Tray Water Connected Appliances Lavatory __3 Water Heater �— Other Fixtures Water Treating System MISCELLANEOUS: ❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor(Trap) gallons(Requires 3 sets of plat u Lawn Sprinkler System-Number of Heads — El Well * x* SJRWD Well Completion Form. Completed form be submitted itted 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 1 have t 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 spec>:5 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 constructiot Property Owners Name Phone Number -;7`f 3� - Plu-nbilZg Company 9�r Office Phone c-;7y`f��/q/ Fax —7 Cis /�G State�Zip, W Co. Address: 2L� A –ly, J�� ty – C LFdense Holder(Print): y,J J S Certification/Registration Sam- ,. F er r'P� SHIRLU 42 L GRAHAM 'nth cS day o 2 Pl/CC)M ISSIGN i DD 957760 work subscribed bef'o EXPTtES:February 14,2014 F.�rdec!?hruNetaryPublicUntlerv;riters gnature Qf NOtary P1I c