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Permit Plumbing 383 Plaza 2013 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 13-00002091 Date 2/12/13 Property Address . . . . . . 383 PLAZA Application type description RESIDENTIAL ALTERATION Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 13SOO ---------------------------------------------------------------------------- Application desc remodel bathroom ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ OBRIEN CHRIS R MIKE BROWN PLUMBING 383 PLAZA 8622 EMERALD ISLE CIR N ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32216 (904) 645-7636 --- Structure Information 000 000 BATH REMODEL Occupancy Type . . . . . . RESIDENTIAL ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc . . REPLACE 3 FIXTURES Permit Fee . . . . 76 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 8/11/13 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . STATE PLBG DCA SURCHARGE 2 . 00 STATE PLBG DBPR SURCHARGE 2 . 00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 76 . 00 76 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 80 . 00 80 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE VLORIDX BUILDING CODES. PLUMBING PERMIT APPLICATION CITY OF ATLANTIC BEACH 3<3 800 Seminole Rd Atlantic Beach, FL 32233 0 Ph(904) 247-5826 Fax (904) 247-5845 -3 '10 61 JOB ADDRESS: PERMIT NEW R REPLACEMENT I ALLATION: Project Value$ 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 t 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: F-1 Sewer Replacement F-1 Back Flow Preventer Ei Grease Interceptor(Trap) gallons(Requires 3 sets of plans) ci Lawn Sprinkler System-Number of Heads El Well **SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection." Ei 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 Phone Number PlumbingCompany IAI ; e_,0 ::TW OfficePhone 61�5-79,?4 Fax 6�M),7 C.-I I Co. Address: &M62,4ta( T-5,657 df4if �J city ::5A-X State 54 Zip 1�2" State Certification/Registration efCp License Holder(Print): Notarized Signature of License Holder -VA-4 Be MEUSSA A.R&AT fore me this day of Peb4&zA44,_ 20 J,5 E 8619M I,2 M ION 017J Janua Co Mls� FES. —7 'u try Pu 'c U. L bl M My y rOMMISSION#EE 8619M EXPIRE&january 1,2017 Signature of Notary Public V_ d d ' No ers on Bonded Thru Notary Pubiic Unde