Permit Plumbing 5116 Polaris Ct 2013 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 13-00002083 Date 2/07/13
Property Address . . . . . . 5116 POLARIS CT
Tenant nbr, name . . . . . . FLEET LANDING
Application type description RESIDENTIAL ALTERATION
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 3100
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Application desc
BATHROOM REMODEL
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Owner Contractor
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NAVAL CONTINUING CARE NAVAL CONTINUING CARE
RETIREMENT FOUNDATION, INC ONE FLEET LANDING BLVD.
1 FLEET LANDING BLVD ATLANTIC BEACH FL 32233
ATLANTIC BEACH FL 322334599 (904) 246-9900
--- Structure Information 000 000 BATH REMODEL
Occupancy Type . . . . . . RESIDENTIAL
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Permit . . . . . . PLUMBING PERMIT
Additional desc . .
Sub Contractor . . ASHLEY PLUMBING CO INC
Permit Fee . . . . 69 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 8/06/13
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Special Notes and Comments
2010 FLORIDA BUILDING CODE, 2008 NATIONAl ELECTRIC CODE
*REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING
DEPARTMENT IMMEDIATELY.
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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 69 . 00 69 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 73 . 00 73 . 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, EL 32233
Ph(904)247-5826 Fax (904)247-5845
JOBADDRESS: a A/" a PERMIT 9
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE oF FixTuRE QTY TYPE oF FixTupx 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
Other Fixtures Water Treating System
MISCELLANEOUS:
o Sewer Replacement Ei Back Flow Preventer o Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
Ei Lawn Sprinkler System-Number of Heads Ei Well
**SJR Well Completion Form. Completed form to be submitted to the Building Department for final inspection."
o Othe 7
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 -i-+ Phone Number
Plumbing Company L 6o Office Phone fS�7 Fax 70 Yt�Ffc>5_3�
Co. Address: city State J-`/Zip2Z-_2_JJ_
License Holder(Print): aIrs A,41?9, "-� z� Sta4eCeAify-ation/Registration#
Notarized Sign
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