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Permit Plumbing 592 Royal Palms Dr 2013 st CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 13-00001974 Date 1/10/13 Property Address . . . . . . 592 ROYAL PALMS DR Application type description PLUMBING ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc 10 fixtures replacement ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ CARTLIDGE, ELIZABETH R CROCKETT PLUMBING COMPANY 592 ROYAL PALMS DRIVE 11331 PENDER RAULERSON RD ATLANTIC BEACH FL 32233 ST. AUGUSTINE FL 32087 (904) 387-0176 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc . . Permit Fee . . . . 125 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 7/09/13 ---------------------------------------------------------------------------- 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 ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. PLUMBING PERMIT APPLICATION CITY OF ATLANTIC BEACH q4 800 Seminole Rd Atlantic Beach, FL 32233 Ph (904) 247-5826 Fax (904) 247-5845 .01 JOB ADDRESS: '5ff IPc,11n,5 PERMIT C/ 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 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: ii Sewer Replacement i-i Back Flow Preventer F-i Grease Interceptor (Trap) gallons(Requires 3 sets of plans) D Lawn Sprinkler System-Number of Heads [:1 Well ** SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection." Ll 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. Property Owners Name 4-sc, ea'd i do-'e, Phone Number PlumbingCompany Z�1_0'etcfr �/411ii_Aqf 4v- Office Phone AN43-1-10,94; Fax 1,043-3-1-009 Co. Address:ABI&k city - State A- zip _;aal License Holder(Print):Itl 1,,Am 7, &�4�roeke�7t7_,T �,7 -vSt ertitfication/Registration Zle 05-77Y Notarized S! nature ofLicense Holde SHIPLEY L.G d subs ed before is (ay To 200 RA Swor an HAD 9 4, Un &AWSSION 01)957760 EXPPES:Febrtiary 14 Bonded Thru Notary Poblir E re of Notary Publicl_� Un