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425 Atlantic Blvd 2013 Repipe CITY OF ATLANTIC BEACH \ is1 J 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . 13-00002479 Date 4/16/13 Property Address . . . . . . 425 ATLANTIC BLVD Application type description PLUMBING ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 --------------------------------------------------------- Application desc REPIPE 7 FIXTURE -------------------------------------------------------- Owner Contractor - ------------------------ ----------------------- MCGUIRE NANCY F.W. FAIR PLUMBING CO. 425 ATLANTIC BLVD P.O. DRAWER 51558 ATLANTIC BEACH FL 322334021 JACKSONVILLE BEACH FL 32250 (904) 241-7191 ----------------------------------------------------- Permit PLUMBING PERMIT Additional desc . . Permit Fee . . . . 104 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 10/13/13 ----------------------------- Other Fees . . STATE PLBG DCA SURCHARGE 2 . 00 STATE PLBG DBPR SURCHARGE 2 . 00 ----------------------------------------------- Fee summary Charged Paid Credited ----Due--- ----- ---------- --------- Permit Fee Total 104 . 00 104 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 108 . 00 108 . 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 Seminole inole Rd Atlantic Beach, FL 32233 aPh(904)247-5826 Fax(904)247-5845. Jos ADDRESS: ,1 '�G' PERMIT## pD NEW OR REPLACEMENT INSTALLATION: Project Value$ Z f TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY Septic Tank&Pit Bathtub Shower Clothes Washer Dishwasher Shower Pan Drinking Fountain Slop Sink Floor Dram Three Compartment Sink Toilet Floor Sink Urinal Hose Bibs Vacuum Breakers Kitchen Sink Water Connected Appliances Laundry Tray Water Heater Lavatory Water Treating System Other Fixtures RE-PIPE: TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY Septic Tank&Pit Bathtub Shower Clothes Washer / Dishwasher Shower Pan Drinking Fountain Slop Sink Floor Drain Three Compartment Sink Toilet —�--- Floor Sink �_ Urinal Hose Bibs �_ Vacuum Breakers Kitchen Sink Water Connected Appliances Laundry Tray �_ Water Heater —�— Lavatory Water Treating System Other Fixtures MISCELLANEOUS: gallons(Requires 3 sets of plans) ❑ Sewer Replacement ❑ Back Flow Prevent er ❑ Grease Interceptor(Trap) ❑ Well ❑ Lawn Sprinkler System-Number of Heads Xx SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection." ❑ Other is or r six s.I hereby certify that I have Permit becomes void if work does not commence within a six month period laws oared ordinances governanng this work will be complied with whether specifiedd this application and know the same to be true and correct. All provisions of 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 inst coon• f Mt Phone NumbeiZ C 5�' V Property Owners Name Z�j��I Z � Fax Office Phone Plumbing Company -� ,� J' State ZipL D /dig T� — City Co.Address: �'6 D 37,�Ca License Holder(Print): �tZ� �R j� tate Certification/Registration# Notarized Signature of License Holder 20� Before me this a Signature of Notary Publi