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128 Pine St 2013 repipe CITY OF ATLANTIC BEACH J 800 SEMINOLE ROAD s� ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 'l !tit Application Number . . . . . 13-00002619 Date 5/06/13 Property Address . . . . . . 128 PINE ST Tenant nbr, name . . . . . . 122 122 - 128 PINE STREET Application type description PLUMBING ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 --------------------------------------------- Application desc repipe 16 fixtures -------------------------------------------- Owner Contractor - ------------------------ ----------------------- HENRY, KATHLEEN ROSS STEEG PLUMBING 12906 BIGGIN CHURCH RD S 1601 MAIN STREET JACKSONVILLE FL 32224 ATLANTIC BEACH FL 32233 (904) 249-5191 ----------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc . . REPIPE 17 FIXTURES . 00 Permit Fee . . . . 174 . 00 Plan Check Fee Issue Date . . . . Valuation . . . . 0 Expiration Date . . 11/02/13 --------------------- ---------------------------- Other Fees . . . . . . . . . STATE PLBG DCA SURCHARGE 2 . 61 STATE PLBG DBPR SURCHARGE 2 . 61 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- - Permit Fee Total 174 . 00 174 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 5 . 22 5 . 22 . 00 . 00 Grand Total 179 . 22 179 . 22 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. PLUNMING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach; FL 32233 Ph(904) 247-5826 Fax (904) 247-5845 JOB ADDRESS: �� W "ne IFERmIT NEW OR REPLACENfENT r STALLATION: Project Valve S OTY T.,FE OF FEUVRE OTY TAPE OF FDU uZ Septic Tank&Pit Bathtub Shower Clothes Washer Dishwasher Shower Pan Slop Sink Drinking Fountain Compartment Drain Three Sink Toilet Floor Sink Urinal Hose Bibs Vacuum Breakers Kitchen Sink Water Connected Appliances Laundry Tray Water Heater Lavatory Water Treating System Other Fixtures -PAPE: ©TY 2—yPE OF FIXTF�RE OTY TYPE OF.�. GVRE Bathtub 2 Septic Tank&Pit Shower Clothes Washer A Shower Pan Dishwasher Slop Sink Drinking Fountain Compartment Comparent Sink Floor Drain Toilet ;_z_- _ Floor Sink Urinal Hose Bibs _ K2 Vacuum Breakers Kitchen Sink Water Connected Appliances Laundry Tray Water Heater Lavatory Water Treating System Other Fixtures NUSCELLANEOUS: allo-ns(Requires 3 sets of pla3 Sewer Replacement o Back Flow Preventer o Grease Interceptor(Trap) Lawn Sprinkler System-Number of Heads _ ❑ Well Department for final inspection. SJRWD Well Completion Form. Completed form to be submitted to the Building Dep o Other certify that I have six this work will be complied with whetber sPe� permit becomes void if work doe s not commence oectl p°o on of laws and o divan ces governing ed or ped for six months-I herey ce of constructiol fnis application and know the same to b anon construon°r the performan or not. The permit does not give authority to violate the provisions of any other state or local law regul Y %W Phone Number Property Owners Name Office Phone f Fax Plumbing Company G L y�� /� City:rk -8 State Zip 33 Co. Address. State Certification/Re9i.stsation License H l Notarized O*J ,y�r � BmM taro Hairy KM e s ed h -nday f - and subs bet r Signature of Notary P ubli