1490 Selva Marina Dr (vault) hof' � 510�•� � �i,,'� -'�`%' - ��>l�� �i4r?.•��.`�
CITY OF ATLANTIC BEACH
APPLICATION FOR PLUMBING PERMIT
PERMIT NO. Date : 1•x17
LOCATION Street
LOT No. �_ BLOCK NO. S/D
OWNER
MASTER FLtJMBER fcJ
BUILDER3�I CONT C� �. Bldg.
ermit_No,.
TYPE OF BUILDING , 2Q1
�_ _ SINKS
LAVATORY BATH TUBS URINALS CLOSETS
FLOOR DRAINS�SHOWERS�WATER HEATERS =DISHWASHERS
DISPOSALS OTHER
TOTAL FIXTURES �.i . 0077
NO WORK MUST BE DONE UNTIL A PERMIT HAS BEEN FROCURED
PLANS AND SPECIFICATIONS must show a plan and. description of the
size,-and location of all the soil and vent pipes, and the numbor and
loeation of all fixtures, (in acgordanae with OrOinanae no. 188 of
the City of Atlantic Beash, Flurida) must be shown on bapk of appli-
cation and be approved by the Plumbing Inspector.
DRAT PLAN AND SPECIFICATION OF ABOVE PLUMBING ON BACK.
Approved by
Plumbing Inspector
Date
FOR OFFICE USE ONLY) -
ROUGH-IN INSPECTED REYARY.S
FINAL INSPECTION: CERTIFICATE ISSUED:
SWIMMING POOL PLANS APPI;OVAL BY HEALTH DIVISIU,,
SUBJECT TO COMPLIANCE WITH CITY ORDINANCE
71.542-174 & VERIFICATION OF DATA PROVIDED IN
HEALTH DIVISION CHECK.OFF LIST.
SIGNATURI.
')ATE
DEPARTMENT OF BUILDIkG FOR OFFICE USE ONLY
CITY OF ATLANTIC BEACH, FtOkTbA Date 19
------- Permit # Fee $ aL, 0-D
Application for Permit Valuation $
fAr Misc. Altetationg House #
and Repairs
DESCRIBE- l/tes-; 'may,/�k � S'GJ,...•..;.�o c� f y�,�'/G�.�'3� r !(� rY/.� � �5.�
- Li',7 �lytL Q<C,C ' " .vTi� CU..'Sy,CCc7!•r
(state 1f to repair, alter) add to or move building, erect awnings
or Signs, etc. )
Building one Lot No. S Blk No. C? Sub.Div.
Address Valuation $
Owner' s Name iy,C 4 MKJ
BUIt,btk7 & OCCUPANCY
Building Use - Residential or Bttaifies
What Plumbing work to be done?
Size of Pretent Bldg. Size of Hxtens on
Lot size Material of Roof
No. of stories now after altered
Material of Present Building Material of Extension
PLANS MU$T BE SUBMITTED HEREWITH
SIGNS
Size Classification
(state whether ground, roof, wall, projecting
banner)
Material of Construction
Illuminated? Type of illumination
(State whether lamps or neon)
Will sign be over public property?
SUBMIT DRAWING SHOWING CONSTRUCTION OF SIGN AND METHOD OF HANGING
WRITE ADDITIONAL INFORMATION BELOW
(For canvas awnings provide dimensioned drawing on reserve side)
IMPORTANT NOTICE:
In consideration of permit given for doing the work as described
in the above statement, we hereby agree to perform said work in
accordance with the attached plans and specifications, which are a
part hereof, and in accordance with the building regulation3 of the
City of Atlantic Beach. Southern Standard Building Code)
Signature of Builder or Owner
Address /rX oelo,9 13,) ,ydC> Pa vLs /,eve . Phone
fly
0 rFt/I-) , T��/r5o,v yrec e�-� 41-4. 312