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885 Amberjack Ln 2013 plumb CITY OF ATLANTIC BEACH J 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 �� ccll INSPECTION PHONE LINE 247-5814 JJ3 '" r !/ 0 Ff O Application Number . . . . 13-00002283 Date 3/08/13 Property Address . . . . . . 885 AMBERJACK LN Application type description PLUMBING ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ----------------------------------------------------------------- Application desc 6 FIXTURES ---------------------------------------------------------- Owner Contractor - ------------------------ ----------------------- ST AMAND SIMONE J TDG PLUMBING 885 AMBERJACK LN 4426 LOYS DRIVE ATLANTIC BEACH FL 322334224 JACKSONVILLE FL 32246 (904) 545-7341 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc . Permit Fee 97 . 00 Plan Check Fee . 00 Issue Date . . . Valuation 0 Expiration Date . . 9/04/13 ---------------------------------------------------------- Other Fees . . . . . . . . . STATE PLBG DCA SURCHARGE 2 . 00 STATE PLBG DBPR SURCHARGE 2 . 00 -------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 97 . 00 97 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 101 . 00 101 . 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 p Jos ADDRESS: 9 �J^ r--.. c PERMIT# NEW OR REPLACEMENT INSTALLATION: Project Value$ TYPE OF FIXTURE QTY TYPE OF FIXTURE QTS' 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 QEiPED 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: ❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor (Trap) gallons(Requires 3 sets of plans) ❑ Lawn Sprinkler System-Number of Heads ❑ Well ** ** SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection." ❑ 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 Number Plumbing Company . -A "n Office Phone%5-4 S'714 ( Fax S'44 - (Tb-.Sr Co. Address: u Ltz,.. Lo*% 0(1- City-,"�'A State FL Zip License Holder(Print):-TIZA'7bre :/�e State Certification/Registration 4 C FC.-I4�--��Z- Notarized Signature of License H e this O ay of 20of Notary P is