2124 S fairway Villas Ln 2012 repipe It SS OF ATLANTIC BEACH.
i f 800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-00001649 Date 11/07/12
Property Address . . . . . . 2124 S FAIRWAY VILLAS LN
Application type description PLUMBING ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
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Application desc
12 fixtures
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Owner Contractor
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NOTTMEIER ERIC & TRACY SYNAN DOUGS DRAINS & MORE
1875 BEACH AVE 2453 BAYWAY CT
ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233
(904) 627-6384
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Permit PLUMBING PERMIT
Additional desc Plan Check Fee . 00
Permit Fee 139 . 00 .
Issue Date . . . Valuation 0
Expiration Date . . 5/06/13
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Other Fees . . . . . . . . . STATE PLBG DCA SURCHARGE 2 . 09
STATE PLBG DBPR SURCHARGE 2 . 09
Fee summary Charged Paid Credited Due--------- ----------
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Permit Fee Total 139 . 00 139 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 18 4 . 18 . 00 . 00
Grand Total 143 . 18 143 . 18 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION �n
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233 I
Ph(904) 247-5826 Fax (904) 247-5845 I
JOB ADDRESS: L PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value $
TYPE OF F/XTURE 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
2
Floor Sink Toilet
�— Urinal
Hose Bibs
Kitchen Sink / Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory 2 Water Heater —1—
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.l 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
�, _s %,1 26C� Office Phone 90`1- �'Z �3��>
Plumbing Company .� 'S ?r
fes, v �v�c 73 oc� Z� City lir reel" State�/ Zip "?L Z 3
Co. Address:
License Holder(Print): 4-1
��sJ�N / State Certification/Registration#
Notarized Signature of License Holder
12-
Sworn and subscribe7befo e this day 0 l� 20
Signature of Notary