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Permit Plumbing 145 Pine St 2013 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 13-00002167 Date 2/19/13 Property Address . . . . . . 145 PINE ST Application type description PLUMBING ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc repipe 8 fixtures ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ WELLS JOHN BENJAMIN JR ET AL F.W. FAIR PLUMBING CO. WELLS CAROL EVANS R/S P.O. DRAWER 51558 145 PINE ST JACKSONVILLE BEACH FL 32250 ATLANTIC BEACH FL 32233 (904) 241-7191 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc . . REPIPE 8 FIXTURES Permit Fee . . . . 111 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 8/18/13 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . STATE PLBG DCA SURCHARGE 2 . 00 STATE PLBG DBPR SURCHARGE 2 . 00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 111 . 00 111 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 115 . 00 115 . 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 JOB ADDRESS: PERMrr 13, o-4o7- 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 k_ Kitchen Sink Vacuum Breakers Laundry Tray Water Connected Appliances Lavatory Water Heater Other Fixtures Water Treating System MISCELLANEOUS: • Sewer Replacement 0 Back Flow Preventer Ei Grease Interceptor(Trap) gallons(Requires 3 sets of plans) • Lawn Sprinkler System-Number of Heads El Well **SJRWD Well Completion Form. Completed-form to be submitted to tFe-Building Department for final inspection." o Other Permit becomes void if work does not commence within a—six month period ori!nrk is su�pended or abandoned for six months.I hereby certify that I haveread this application and know the same to be true and correct. All provisions of la, S armordinances governing this work will be complied with whether specified or not. 'ne permit does not give authority to violate the provisions of any other state "N cal law regulation construction or the performance of construction. Property Owners Name J0 Ho 0 10 Phone Number%3,y �d 7 Plumbing Company L_ Office Phone Jax 2/7 Co. Address: . city 15? 6 State�t Zip 1�2� License Holder (Print): ate Certification/Registratior�lt–l�� Notarized Signature of License Holder MEUMk HART Sworn and subscribed ore me this day of P., My COMMISSION#EE861935 (44:6�gLl�200 EXPIRES:January 1,2017 Signature of Notary Public jW,'R'F SwdW Thru Notary Pubic UndmOn