880 Beach Ave Plumb 2012 o l n j`I:r
CITY OF ATLANTIC BEACH
1 800 SEMINOLE ROAD
J ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
�Ji3
Application Number . . . . . 12-00001709 Date 11/16/12
Property Address . . . . . . 880 BEACH AVE
Application type description PLUMBING ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
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Application desc
WATER HEATER
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Owner Contractor
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HINES, ROBERT & VICKIE ATLANTIC COAST PLUMBING CORP.
880 BEACH AVENUE 3653 REGENT BLVD #305
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32224
(904) 249-5381
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Permit . . . . . . PLUMBING PERMIT
Additional desc . . . 00
Permit Fee . . . . 62 . 00 Plan Check Fee
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 5/15/13
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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 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.
Nov 16 12 01 : 24p Susan Parrish
904-246-3673 P• 1
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800-Seminole Rd Atlantic.Beach,FL 32233
Ph(904)247-5826 Fax(904)247-5845
roe A�DRM: r" 1?Fauv>ocr#
NEW O PACE INSTALLATION: Project Value S
TYPE LQF QTY TYPE o,FFECMRE 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: -
7 PE of FEODURE QTY TYPEOFFMWRE QTY'
Bathtub Septic Tank&Pit _
Clothes Washer Shower
Dishwasher Shower Pan _
DooDrs Slop
FlThre
Compartment Sink
Floor Sink Toilet —
Hose Bibs Urinal —
Kitchen Sink Vacuum Breakers _
Laundry Tray Water Conncoted Appliances
Lavatory Water Heater
Other Fixtures 'Water Treating System _
NQSCELLANEOUS:
❑Sewer Replacement 0 Back Flow Preventer u Grease Interceptor(Trap) gallons(Requires 3 seta of plans)
❑ Lawn Sprinkler System-Number of Heads D Well
** SJBWD Well Completion Form. Completed formto be submitted to the Building Department for final inspection.**
0 Other
Permit becomes void if work does not commence within a sur month period or work is suspended or abandoned for six months I hereby cctdfy that I have read
this application and]mow t1c same to be time and effma. All provisions of laws and ordinances governing this work will be am:ipticd with whether specified
or tot. The permit does not give authority to violate the provisions of airy other state or local law regulation oonsttuc:tioa or the,performance of construction.
Property Owners Name �'�i Ci 6 Phone Number—g,4- 2,21- _
Plumbing Company Y ffice Phone 7. 3�;7� Fax '�31f
Co.Address: 5 �i s7 City ,]i5 State L Zip
License Holder(Print): !' Q
Z21 J
State Certification/Registra ion# ALO�o v
Notarized Signature of License Holder
Iol/ °�
worn and subscribed before met s��da of 20-�
MANE 0.ROCHE
.+. Notary Public-State o1 Florida igna[ttre of Notary Public
MY comm.Expires Apr 15,2013
Commission#DO 880914 -
•••, �,•,• Bonded ThroughNatlaualNotaryAtin