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127 Fleet Landing Blvd plumb 2013 s� CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . 13-00002816 Date 6/07/13 Property Address . . . . . . 127 FLEET LANDING BLVD Application type description PLUMBING ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 -------------------------------------------------- Application desc 1 fixture --------------------------------------------------- Owner Contractor - ------------------------ ----------------------- NAVAL CONTINUING CARE DAVID GRAY PLUMBING INC. RETIREMENT FOUNDATION, INC 6491 POWERS AVENUE 1 FLEET LANDING BLVD JACKSONVILLE FL 32217 ATLANTIC BEACH FL 322334599 (904) 724-7211 ------------------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc . Permit Fee . . . . 62 . 00 Plan Check Fee 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 12/04/13 ------------------------------- Other Fees . . STATE PLBG DCA SURCHARGE 2 . 00 STATE PLBG DBPR SURCHARGE 2 . 00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due --------- ---------- --------- Permit Fee Total 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. PLUMBING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach, FL 32233 Ph(904) 247-5826 Fax (904) 247-5845 p � �rnCC .� Y � i til Pyr# JOB ADDRESS: / /e4�L�f ,� p NEW OR_REPLACEMENT INSTALLATION: Project Value $ TYPE of FIXTURE QTY TYPE OF FmvRE 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 l Other Fixtures Water Treating System RE-PIPE: TYPE OF FEUVRE QTY TYPE OF FEYT URE 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 ** *--ISJRWD 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 �f4_rf /,y Phone Number 1i'` '� Plumbing Company DAVID GAY PLUMBING, INC. Office Phone 724-7211 Fax Co. Address: 6491 Powers Avenue city Jacksonville,_FL 32217 License Holder(Print): David F Gray State Certification/Registration# CFC 022MO N i e ature of License Holder rof.y"�y Notary Public State of FloridaSworn and subscribed before me this y o N� 20f 3 Neal R Major - 1 My Commission EE032510 Q Expires 12/20/2014 Signature of Notary Public