Permit & Plans Res Alt 1072 Beach Ave 2012 �� CITY OF ATLANTIC BEACH
J
it 800 SEMINOLE ROAD
f - X ATLANTIC BEACH, FL 32233
\\.„,.,.._: INSPECTION PHONE LINE 247-5814
Application Number 12-00001718 Date 12/05/12
Property Address 1072 BEACH AVE
Application type description RESIDENTIAL ALTERATION
Property Zoning TO BE UPDATED
Application valuation . . . 68500
Application desc
kitchen remodel and add moning kitchen
Owner Contractor
SUAREZ JACQUELINE E GRIDER CONSTRUCTION INC
1072 BEACH AVE 2057 VELA NORTE
ATLANTIC BEACH FL 322335754 A(90LANTIC3BEACH FL 32233
Structure Information 000 000 KITCHEN REMODEL/ADD 2ND MORNING KITCHEN
Occupancy Type RESIDENTIAL
Permit PLUMBING PERMIT
Additional desc .
Sub Contractor . TDG PLUMBING Plan Check Fee 00
Permit Fee . . . • 62 . 00 0
Issue Date . . . . Valuation . . •
Expiration Date . . 6/03/13
Special Notes and Comments
2010 FLORIDA BUILDING CODE, 2008 NATIONAL ELECTRIC CODE
*REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING
DEPARTMENT IMMEDIATELY.
Other Fees STATE PLBG DCA SURCHARGE 2 . 00
STATE PLBG DBPR SURCHARGE 2 . 00
Fee summary Charged Paid Credited Due
Permit Fee Total 62 . 00 62 . 00. 00 . 00 . 00. 00 . 00
Plan Check Total . 00 4 . 00 . 00 . 00
Other Fee Total 4 . 00 66 . 00 . 00 . 00
Grand Total 66 . 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
JOB ADDRESS: /' 7Z ,fc 0/f /vg PERMIT# / -0000 0718
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 l 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 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 4.-• 4,....8, t f\ ) * "C‘e 'Tv\A k-e
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 authority to violate the provisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name S G01 rt e Z Phone Number
Plumbing Company o_ ?U.N^ b■/ a f.' Office Phone rti.S=7%4( Fax SLR{- I i C R
Co. Address: LC Li'4.4 Lo%- 3 O0- City- Psr" State FL Zip %),"24 1"
License Holder(Print): Av; Q 6 Plr•'\e State Certification/Registration# CFC-i 42=1O(I t
Notarized Signature of License Holder_. ay of �G C 20 /Z
":.,H�� y L.GRA orn fd subscribed before =k - ;
a .� t, ,._ h (ipgn ,r, ,'•'1D 957760
EXP�R-S F�bru y Sift of Notary Publi
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