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
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Application desc
bath remodel
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Owner Contractor
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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
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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
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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 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
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MA MMISSION#EE86IW5
ignature of Notary Public EXPIRES:January 1,2017
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