700 Amberjack Ln 2012 repipe CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
'J - = ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Jit Vii?
Application Number . . . . . 12-00001696 Date 11/14/12
Property Address . . . . . . 700 AMBERJACK LN
Application type description PLUMBING ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
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Application desc
1 NEW 10 REPIPED FIXTURES
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Owner Contractor
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FORE, FRANCIS CHRISTY FIRST COAST PLUMBING
700 AMBERJACK LANE 1651 MAYPORT RD
ATLANTIC BEACH FL 322334202 ATLANTIC BEACH FL 32233
(904) 247-4419
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Permit . . . . . . PLUMBING PERMIT
Additional desc . . 1 NEW 10 REPIPED FIXTURES
Permit Fee . . . . 132 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 5/13/13
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Other Fees . . . . . . . . . STATE PLBG DCA SURCHARGE 2 . 00
STATE PLBG DBPR SURCHARGE 2 . 00
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 132 . 00 132 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 136 . 00 136 . 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
f
JoB ADDRESS: /r(� .+✓n C x'12 Get, PERNUT#
(NEW OR REPLACEMENT INSTALLATION: Project Value$
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 I 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 autltority to violate the provisions of any other state or•local law regulation construction or the performance of construction.
Property Owners Name % i L,: ' (':; i- Phone Number 71
J
Plumbing Company 5 1651 Ma ort Road Office Phone '' Fax C
Co. Address: ar&J46 hr. Atlantic Beach, FL 32233 cit, State zip
License Holder(Print): State C tion/Registration#C,
Notarized Signature of License 14older - —
,�•e4 . _ JULIE YOUNG CHRISTY Sworn and subsc rem 's day of 20
t KW COMMfSSION#DD 673233
EXPIRES:July 21,2013 Signature of y Nota"rPublic
F ' Bonded Thru Notary Public Underwriters " J