Permit Plumbing 680 Mayport Rd 2013 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number 13-00002014 Date 1/17/13
Property Address . . . . . . 680 MAYPORT RD
Application type description PLUMBING ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
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Application desc
sewer replacement
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Owner Contractor
----------------------- - ------------------------
ATLANTIC BEACH ASSEMBLY OF GOD HARRY L HAYES PLUMBING INC
680 MAYPORT RD 6837 OAKWOOD DR
ATLANTIC BEACH FL 322333424 JACKSONVILLE FL 32211
(904) 723-5609
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Permit . . . . . . PLUMBING PERMIT
Additional desc . .
Permit Fee . . . . 62 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 7/16/13
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Other Fees . . . . . . . . . STATE PLBG DCA SURCHARGE 2 . 00
STATE PLEG DBPR SURCHARGE 2 . 00
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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 N'VITH 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 �'o
Ph(904) 247-5826 Fax (904) 247-5845
JOB ADDRESS: (_P18C> Mc:,S.4:Dej-C--J -12- 1h '_39La'3L__22" PERMIT#
'J I
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
MJXELLANEOUS:
,V'Sewer Replacement n Back Flow Prevente� r-i Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
ii Lawn Sprinkler System-Number of Heads ii Well
** ,VRWD Well Completion Form. Complete be submitted to the Building Department for final inspection."
D 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 visions of laws and ordinances goveming 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.
4.1!7 - R-,-, c5VG5,!,9APhone Number
Property Owners NameAi I<:,� cac--
Plumbing Company JA c-,<-r,., _tk so�� 7 1,..A��, TIng-Office Phone I-Z3-:5(.,,C�Fax_3���
Co. Address:5 J -At A-r-c�,- OA A7,,jr-_ city state"F�_ zip-322jj
License Holder(Print): LL - - State Certification/Registration#c:.f;::; t ql_77!�ffy
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