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781 Camelia St 2012 repipe CITY OF ATLANTIC BEACH j 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 12-00001710 Date 11/19/12 Property Address . . . . . . 781 CAMELIA ST Application type description PLUMBING ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc Repipe 10 fixtures ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ SCHRADER MATTHEW H DAVID GRAY PLUMBING INC. 781 CAMELIA ST 6491 POWERS AVENUE ATLANTIC BEACH FL 322332547 JACKSONVILLE FL 32217 (904) 724-7211 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc . . REPIPE 10 FIXTURES Permit Fee . . . . 125 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 5/18/13 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . STATE PLBG DCA SURCHARGE 2 . 00 STATE PLBG DBPR SURCHARGE 2 . 00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 125 . 00 125 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 129 . 00 129 . 00 . 00 . 00 PERMIT IS APPROVED ONLI' IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. Mar 08 10 12:54p Information SystemsClTY 0 904-247-5845 p•1 PLUMBING F]EUN TT APPLICATION CTT ' OF ATLANTic BEACH 800 Seminole Rd Atlantic Beach,FL 32233 Ph(904)247-5826 Fax(904)247-5845 JoB ADDRESS: -78/ �� Q �� PERNUT# NF W OR REPLACF3MNT INSTALLATION: Project Valve $ TYPE oFFIXT pE QTY TYPE: or FIXTURE QT' Bathtub Septic Tank&Pit Clothes Washer Shower Dishwasher -Shower Pau gSlo Sink Floor Dram in Three Compartinent Sink Floor Sink Toilet Hose Bibs Urinal Kitchen Sink Vacuum Breakers Laundry Tray Water Connected Appliances Lavatory Nater Heater Other Fixtures Water Treafmg System TYPE of�'tuu- E' QTY 7�YPE oi•F�E QTY 'Bathtub i Septic Tank&Pit Clothes Washer � Shower L— Dishwasher Shower Pan DrirtlQng Fountain Slop Sink Floor ina F Three Compartment Sink Toilct Z Floor Sink U-inat Hose Bibs Kitchen Sires / VacuumBreak_er Water Connected Appliances Tray 7— Lavatory � Water Heater Other Fixtures Water Treating System N'ISCELLANEO[TS ❑ Grease Interceptor(Trap) gallons( equ=zzs 3 sets of pts ❑ Sewer Replacement C3 Back Flaw Preventer ❑ Lawn Sprinkler System Number of Heads ❑ Well tt & 7]ZWD Ffell Campletior.Forth. Completed farm to be submitted to the Building Department for X21 inspection.** ❑ Other Permit becomes raid if work does not commence within a six month peri or work is 5- :+ended or abandoned for six months.I hereby ccrti: tha I have rza_d this application and know the same to be true and correct. All provisions of laws and ordinances governing Ibis work will be complied with whether spe`i 1,-d or not The pe,,nrit does not give authority to violate th provisions of any oth state law regulation construction or the performance of cos 7�� Property Owners Name �P�/ c �� Phone Number 3 C i z Day ri G;r v Plumbing, Inc. OfEce Phone - Fax-7;4;- Plumbing 7;4 -Plumbing Company ourt. State Co. - ,v Cly' Zip Address: ,_ ._,_ _:_ ,_-„� License Holder(Print): 1State Certification/Registration e- G F-1: O�E Nota ' S' :mature of License Holder Of 4? f 20� ,,P°oi�n Notary public State of Florida and subscribed before to t111S l / d _ f Neal R Major .-.�o` MY Commssiun EE032510 S e of Notary PubPic Expires 12/20/2010