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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 ---------------------------------------------------------------------------- Application desc 1 NEW 10 REPIPED FIXTURES ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ FORE, FRANCIS CHRISTY FIRST COAST PLUMBING 700 AMBERJACK LANE 1651 MAYPORT RD ATLANTIC BEACH FL 322334202 ATLANTIC BEACH FL 32233 (904) 247-4419 ---------------------------------------------------------------------------- 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 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . STATE PLBG DCA SURCHARGE 2 . 00 STATE PLBG DBPR SURCHARGE 2 . 00 ---------------------------------------------------------------------------- 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