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1915 Creekside Cir plumb 1 fixture 2013 CITY OF ATLANTIC BEA 800 SEMINOLE Rb ATLANTIC BEACH,FL 32233 Application Number . . . . . 13-00002407 Date 4/02/13 Property Address . . . . . . 1915 CREEKSIDE CIR Application type description PLUMBING ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc 1 fixture ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ MADDY JERALD D & SALLY C ATLANTIC COAST PLUMBING CORP. 1915 CREEKSIDE CIRCLE 3653 REGENT BLVD #305 ATLANTIC BEACH FL 322334505 JACKSONVILLE FL 32224 (904) 249-5381 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc . . Permit Fee . . . . 62 . 00 Plan Check Fee . 00 Issue Date . . . . valuation . . . . 0 Expiration Date . . 9/29/13 -------------------------------------------------------------------------- Other Fees . . . . . . . . . STATE PLBG DCA SURCHARGE 2 . 00 STATE PLBG DBPR SURCHARGE 2 . 00 ----------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 62 . 00 62 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 66 . 00 66 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. Apr 02 13 11 : 09a Susan Parrish 904-246-3673 p. l PLUMBING PERMIT APPLICATION CYTY OF ATLANTIC BEACH 800.Seminole Rd Atlantic Beach, FL 32233 Ph(904)247-5826 fax(904)247-5845 JoB ADDRESS: `'y �' ��S�d G �•' Pa:RMrie# NEW O 'REPLACEMENT STALLATION: Project Value$ TYPE OF FLXTmw gry T vPE UFFbavRE QTY Bathtub Septic Tank 8i;Pit Clothes Wasbcr Shower Dishwasher Shower Pan Drinking Fountain. . Slop Sink Flo"Dram Three Compar bment Sink Floor Sink Toilet Hose Bibs Urinal 3 Kitchen Sink Vacuum Breakers Laundry Tray Water Connected Appliances Lavatot�► _ Waw Heater C1her Fudures Water Treating Sysmm RE-PIPE: TYPEOFFWRs QTY 2YPEOFFbrwRrs QTY Badrtub Septic Tank&Pit Clothes'Washer Shower Dishwasher Shower Pon Drinking Fountain Slop Sink Floor Drain Three Compartment Sink Floor Sink Toilet Hose Bibs Urinal Kitchen Sink Vacuum Breakers Laundry Tray Water Conncctod Appliances Lavatiory Wim'Heater Other Fuctums Water Trcaflag System AUSCELLANEOUS: ❑Sewer Replacement D Back Flow Preveater ❑Grease Interceptor(Trap) gallolls(Requires 3 sets of pians) D Lawn Sprinkler System Number of Heads ❑ Well �* **SJRWD Well Completion Form. Completed formto be submitted to the Biding Department forfinal inspection.* 0 Other Perunit bocomes void if work does not cotrrmence within a six month Period 07 work is suspended or abandoned for six montm I hereby certify that I have reed this application and know the same to be true and carom All provisions of laws and ordinances governing this work will be complied with whether speaifie4l or not, The pemtit docs not give authority to violate tht provisions of any other state or local law regulation construction or 1he perfotmce of consaucdon. Property Owners Name .-n r YY-,A, Phone Number" ��r� 5. Plumbing CompanyYOfftce none co.Aaaz 3r7� �� % ;f , a.1 city state License Solder(Print): /'1'1' - tate catioa/Registration# Notarized Signature of License Holder ........ „I,V DIANE o.RocHE worn and subsGriht be re ITIe this � day of �"'% � 24 s Notary Public-state of Florida •_/ty Comm.Expires Apr 15.2013 il;wt a of Notary Public Commission f Do 9140919 �'�bi;�1 ' Baed+d lit cagh Nall"MataatyAsea.