Permit Plumbing 249 S Nautical Blvd 2013 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 13-00002067 Date 1/29/13
Property Address . . . . . . 249 S NAUTICAL BLVD
Application type description PLUMBING ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
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Application desc
1 fixture
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Owner Contractor
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PUNDAMIERA, BEN V PONCE PLUMBING, INC.
249 NAUTICAL BLVD. SO. 4642 COLLEGE ST
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32205
(904) 388-7502
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Permit . . . . . . PLUMBING PERMIT
Additional desc . .
Permit Fee . . . . 62 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 7/28/13
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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
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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.
2011-*08 17;35 AGS INSTALLATIONS 9042470535>>+1.904.592.6590 p III
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beachl FL 32233
Ph(904)247-5826 Fax(904)247-5845
On
JOB ADDRIESS., PERmrr N
NEW OR REPLACEMENT INSTALLATION: Project Value S
TYPE OF FixruRE 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:
TYPEOFFixruRE QTY TYPE OF FiXTURE Qry
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 Reater
Other Fixtures Water Treating System
MISCELLANEOUS:
0 Sewer Replacement El Back Flow Preventer 0 Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
o Lawn Sprinkler System-Number of Heads Ei Well
**,VRWD Well Complelion Form.Completed form to be submitted to the Building Department for final inspection.**
Li Other
Permitbccomcs void ifwork does ot commence within a six month p iod or work is suspended or abandoned for six months.I hereby ccrtify that I have read
tZ application and know the same to bc truc and correct. All provisions of laws and ordinances governing this work will be complied with whether specified
or not. The pomit docs not givc duthon, to vio atc the visions of any other state or local law regulation construction or the performance of construction,
Property Owners Name Phone Number 2 5//,,p-
plumbing Company OfficePhone SW`75�:,L_ fim
Co. Address: 4(,, t>1,��t_ City
Statev-_�Zip -'s
License Holder(Print):--r Vi- State Certification/Registration 4 C�—_Ck 4 2:_P�'l
Notarized Signature of License Holder T__
Sworn andsubscribed before rne th is'3 -a—,.
:_2()
AM HA'(NIzb
Signature of Notary Publice, 3
[:L&EJgZ)tfiaQa5 4
E PIRES October 18,2014
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:(407)398-0153 FlorldallotaryService��J