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
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Application desc
10 fixtures replacement
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Owner Contractor
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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
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Permit . . . . . . PLUMBING PERMIT
Additional desc . .
Permit Fee . . . . 125 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 7/09/13
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Other Fees . . . . . . . . . STATE PLBG DCA SURCHARGE 2 . 00
STATE PLBG DBPR SURCHARGE 2 . 00
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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
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&AWSSION 01)957760
EXPPES:Febrtiary 14
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