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731 Cavalla rd sewer replacement 2012 CITY OF ATLANTIC BEACH J 800 SEMINOLE ROAD j � ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 � it Application Number . . . . . 12-00001611 Date 10/31/12 Property Address . . . . . . 731 CAVALLA RD Application type description PLUMBING ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 2000 ------------------------------------------------- Application desc Sewer Replacement ---------------------------------------------- Owner Contractor - ------------------------ ----------------------- SMITH JOSEPH A BILL FENWICK PLUMBING 731 CAVALLA RD 8245 BEACH BLVD ATLANTIC BEACH FL 322333916 JACKSONVILLE FL 32216 (904) 724-7022 --------------------------------------------- Permit PLUMBING PERMIT Additional desc SEWER REPLACEMENT . 00 Permit Fee 62 . 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 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 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 800 Seminole Rd Atlantic Beach, FL 32233 Ph (904) 247-5826 Fax (904) 247-5845 JOB ADDRESS: ��I ( Owalka R gad '1 2Z �� PERMIT# NEW OR REPLACEMENT INSTALLATION: Project Value $�,� DU 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 ** 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 � �`� Phone Number 9()`s-2 L4(Q-6-15`1 Plumbing Company Office�P,hone�(� (-�2`�-_)b22Fax 121-$$Gq Co. Address: �2�i5ac_h ��vaxd City �1uCILY�N��2 State Zip 3221 License Holder(Print): rJIJ A\CLM -�Qnw,\dC State Certification/Registration# C�C Notarized Signature of License Holder LC._ BROOKE F DOWNING Sworn and sub ri d before me this day `onf 0�� 20 �Z _ • : MY COMMMS M*EE143301 Signature of Notary PublicVW* �l `�1 ' EXPIRES Novwnbw 02,2015 ,407 �75i eam