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Permit Plumbing 1610 Coquina Pl 2012 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 ell Application Number . . . . . 12-00001827 Date 12/17/12 Property Address . . . . . . 1610 COQUINA PL Application type description PLUMBING ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc 1 water treatment system ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ SMITH MARK S AFFORDABLE WATER/KINDER INC 1015 ATLANTIC BLVD SUITE 99 3760 KORI ROAD ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32257 (904) 262-0197 ---------------------------------------------------------------------------- Permit ' * * * * * PLUMBING PERMIT Additional desc . - Permit Fee . . . . 62 . 00 Plan Check Fee . 00 Issue Date . . . . valuation . . . . 0 Expiration Date . . 6/15/13 ---------------------------------------------------------------------------- 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 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. PLUMBING PERMIT APPLICATION CITY OF ATLANTic BEACH 800 Seminole Rd Atlantic Beach, FL 32233 Ph (904) 247-5826 Fax (904) 247-5845 JOBADDRESS: %(01C) COO 4tMAPictice_, AJkcir)Vtc_ 'T)ecicVN IFL -3-1233 PERMU# NEW OR REPLACEMENT INSTALLATION: Project Value s Cc 1 00 TYPE OFFixTURE QTY TYPE OFFixTURE QTY Bathtub Septic Tank & Pit Clothes Washer Shower Dishwasher Shower Pan Drinking Fountain Stop 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 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 0 Back Flow Preventer Ei 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." ii 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 authority to violate the provisions of any other state or local law regulation construction or the performance of construction. (104) 239-0Z3 Property Owners Name f-0 a v-K S M',I Phone Number 904-marsi Plumbing Company AfforcA cLWe W4ej- OfficePhonet04-*2C?--019-1 ' Fax -z6o -16-L9 Z Co. Address: -3960 koR:t Roa8 City 3-AcRSOnu tile- StateFL zip -�Z-25'-J License Holder(Print): MARK A. k6t,40EP, State;C_rt,fication/Registration# Holder i4e-1 zl::4r. __7 & ( -D m ov ft,;P, Notary Public State of Florida 14 %:�' r- 20 day onf ., Sworn and subscribed bref me this P Dorothy M Devore F My Commission DD840269 lie Expires 02/09/2013 or 1vo Signature of Notary Pu lie