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Permit Plumbing 298 Pine St 2013 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 13-00002186 Date 2/21/13 Property Address . . . . . . 298 PINE ST Application type description PLUMBING ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc 3 fixtures ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ BERNSTEIN SKINNERS PLUMBING 298 PINE STREET 1416 ARLINGTON AVE ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32211 (904) 727-7000 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc . . Permit Fee . . . . 76 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 8/20/13 ---------------------------------------------------------------------------- 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 ALI, 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: 29 P-CN& STRO�;T PERMIT # NEW OR REPLACEMENT INSTALLATION: Project Value $ ?00,,0V TYPE OF FixTURE QTY TYPE OF FixTURE QTY Bathtub Septic Tank&Pit Clothes Washer Shower Dishwasher Shower Pan I 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: [-i Sewer Replacement Ei Back Flow Preventer El Grease Interceptor (Trap) gallons(Requires 3 sets of plans) D Lawn Sprinkler System-Number of Heads El Well ** SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection." El 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 Number2% ?2S-9/&3 PlumbingCompany SkZ7VAA(�—t PiSC _CIVC, Office Phone V�Z?/9>09Z Fax20�720Z:�X Co. Address: JL111(0 fiAL- State �--)_ Zip _VZ// )94/6, City '07,4 k License Holder (Print): /L_'PA'y1e_ Z&& S-In-1VIV46115 State Certification/Registration # Notarized Signature of License Holder - ------ inH day -e-l" )Tq 6� 20 ttL _�HIRLEY L.GRAHAM .......... EmV6%' Q"4M"ta:: Pub JAJ n Bonded Thn,Notary Public Underwriters