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Permit Plumbing 522 Aquatic Dr 2013 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 13-00002124 Date 2/08/13 Property Address . . . . . . 522 AQUATIC DR Application type description RESIDENTIAL ALTERATION Property Zoning . . . . . . . PLANNED UNIT DEVELOPMENT Application valuation . . . . 1800 ---------------------------------------------------------------------------- Application desc bath remodel ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ BALWIN ARLENE D ET AL S.E.JONSSON CONSTRUCTION, INC. 522 AQUATIC DRIVE 8 STARFISH PLACE FLEMING SUSTAN T/C PONTE VEDRA BEACH FL 32082 ATLANTIC BEACH FL 32233S174 (904) 545-2714 --- Structure Information 000 000 BATH REMODEL Occupancy Type . . . . . . RESIDENTIAL ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc . . REPLACE THREE FIXTURES Permit Fee . . . . 76 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 8/07/13 ---------------------------------------------------------------------------- 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 FLORIDA BUILDING CODES. PLUMBING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach, FL 32233 Ph(904)247-5826 Fax (904)247-5845 "b 212- JOBADDRESS: aaa A, "6-, . PERMIT # 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 res Water Treating System MISCE=US: F-1 Sewer Replacement o Back Flow Preventer F-1 Grease Interceptor (Trap) gallons(Requires 3 sets of plans) 1:1 Lawn Sprinkler System-Number of Heads 1:1 Well **SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection." El Other Permit beco*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 Ar kytt- "Bak 61 zI Phone Number Plumbing Company -Amli 0%�I kt-tbi kdTl�- Office Phone-2410-0%6'60 Fax Co. Address: aSD-1 city State F1 Zip:�Z244 License Holder(Print): State rti 1 tion/Registration# 0-,r t_0_-yqAL 74- 1 Notarized��ignaturea4License Holder Z_") OA efore me this day of MELI A SUA HW A MA MMISSION#EE86IW5 ignature of Notary Public EXPIRES:January 1,2017 th~9M