Permit Plumbing 810 Cavalla Rd 2013 CITY OF ATLANTIC BEACH
s) 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
........... . u.
INSPECTION PHONE LINE 247-5814
Application Number . . 13-00002056 Date 1/28/13
Property Address . . . . . . 810 CAVALLA RD
Application type description PLUMBING ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . 2500
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Application desc
REPIPE 9 FIXTURES
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Owner Contractor
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WILBURTH JOHN FENWICK, BILL PLUMBING, INC.
13825 BELLE RIVA LANE 8245 BEACH BOULEVARD
JACKSONVILLE FL 32225 JACKSONVILLE FL 32216
(904) 724-7022
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Permit . . . . . . PLUMBING PERMIT
Additional desc . . REPIPE 9 FIXTURES
Permit Fee . . . . 118 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 7/27/13
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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 118 . 00 118 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 122 . 00 122 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC: BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
01/28/2013 08:43 9047248869 FENWICK PLBG PAGE 01
PLUMBI G PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Sem" ole Rd Atlantic Beach, FL 32233
Ph (904)47-5826 Fax(904) 247-5845
JOB ADDRESS: i Q Cly.V PEWYUT# /3
l
NEW OR REPLACEMENT INSTALLATI6N: Project Value $ )_6QQ
TYPE oFFIXTURE QT> i TYPE oFFixruRE QTY
Bathtub _ Septic Tank&Pit
Clothes Washer Shower
Dishwasher _ Shower pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink _T Toilet
Hose Bibs �_ Urinal
Kitchen Sank ._.i. Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
RE•PIPE:
TYPE of FIXTURE QT11 TYPE of FIXTURE QTY
Bathtub _ Septic Tank&Pit
Clothes Washer _ Shower r
Dishwasher �� Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet 2-
Hose Bibs Urinal
,Kitchen Sink _ Vacuum Breakers
Laundry Tray Water Connected Appliances v
Lavatory �� Water Heater J_
Other Fixtures _ Water Treating System
MISCELLANEOUS:
❑ Sewer Replacement 0 Back Flow Preventor ❑ Grease Interceptor(Trap)_ gallons(Requires 3 sets of plans)
❑ Lawn,Sprinkler System.-Number of Heads ❑ Well
SJR WD Well Completion Form. Completed 1 onn to be submitted to the Building Department for final inspection.*
❑ Other
Pcnmit bccomcs void if work does not commence wi%in a six 0onth period or work is suspended or abandoned for six months.l hereby certify that t have read
this application and know the same to be true and correct. All rovisions 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 Nance -f ohn t l 1 iQi , __ Phone Number l 3- `?7 2
Plumbing Company e� /�Ftsjl C'L P1 W! M bl u Office Phone 04 gaqqoa,_Fa �m14) 9-46
Co. Address: • &aLk. tiva, City La-4LW r,-v l le State ';"t. Zip 322 tt.
License Holder(Print): I1 fene ii CEr- State Certification/Registration#�,`FO—y40039
,il rized Signature of License Holder
■KOOKS F DOWMWG Sworn and �ubscri before me this _ !. day of Ay1WA ,N _20�5
MY=6011"ON N RE143391
EXPIRES NWM"*W 09.2t]13 Signature of Notary Public_
114n)In 0 n oMn
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph (904) 247-558-2J6 Fax(904) 247-5845
JOB ADDRESS: Q V( ICC PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value $ 2-600
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 t Shower 1
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet 2-
Hose
Hose Bibs I Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory L Water Heater I
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
**SJR WD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.**
❑ 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 _-� 0
ohn t f L h Phone Number FS l 3- 9-7 Z3
Plumbing Company lbuj lw t Ck P l uf-n Fj l u Office Phone 0ql ' Aq r)a ZZ Fa4go—))-1a4 K'G 5
Co. Address: 3a�l aac-ii_ 4-AVC4- 4 City S ,w --uiI State fit- Zip32,2-1(.
Li nse Holder(Print): State Certification/Registration#C re-CH 00 39
1V arized Signature of License Holder .C1t 0 ltd �1 C�
' BROOKE F DOWNING Sworn and subscri before me this day of 36 IR (N 20 3
*: MY COMMISSION#EE143391
EXPIRES November 02.2015 Signature of Notary Public
pOT)3Y60/S7to
.=m