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668 Selva Lakes Cir 2013 2 fixtures CITY OF ATLANTIC BEACH 1 j 800 SEMINOLE ROAD J ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 13-00002571 Date 4/30/13 Property Address . . . . . . 668 SELVA LAKES CIR Application type description PLUMBING ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc 2 fixtures ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ FOX THOMAS FOX STEEG PLUMBING 668 SELVA LAKES CIR 1601 MAIN STREET ATLANTIC BEACH FL 322334377 ATLANTIC BEACH FL 32233 (904) 249-5191 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc . . Permit Fee . . . . 69 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 10/27/13 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . STATE PLBG DCA SURCHARGE 2 . 00 STATE PLBG DBPR SURCHARGE 2 . 00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 69 . 00 69 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 73 . 00 73 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. PLIJ113IN O PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach. FL 32233 Ph(904) 247-5826 Fax(904) 247-5845 JOB ADDRESS: �!� 9 �d i-k'i � � PFRmrr 1#1 NEW OR REPLACEMENT V STALLATION: Project Value S T<TE OF FDffURE On, TYPE oFFDa-V7zE Ory Bathtub Septic Tank&Pit Clothes Washer Shower Dishwasher Shower Para 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 FMURE ®TY TYPE oFFDUTJRE ory 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 pta; ❑ 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�fY that I have; this application and know the same to be true and correct All provisions of laws and ordinances govern n cons construction e rmance of c nstru�rn or not. The permit does not give authority to violate the provisions of any other smote or local law regal f � Phone Number Property Owners Name 0 Plu-nbu-lg Company e� l� 419 —Office Phone Zz33 City State�=zip— Co.Address: �� idiy' !,eltD 7/9& License Holderl" �" x-11 '41rant • S State Certification/Registration„ r :`cfara4e Siartatt€re©�j Lice e Facer Sworn al-rd scribed bef6r me this________day of 20_ Signature of Notary Public