5829 Fleet Landing Blvd water sftnr 2013 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 13-00002883 Date 6/14/13
Property Address . . . . . . 5829 FLEET LANDING BLVD
Application type description PLUMBING ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
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Application desc
water softner
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Owner Contractor
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NAVAL CONTINUING CARE AFFORDABLE WATER/KINDER INC
RETIREMENT FOUNDATION, INC 3760 KORI ROAD
1 FLEET LANDING BLVD JACKSONVILLE FL 32257
ATLANTIC BEACH FL 322334599 (904) 262-0197
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Permit . . . . . . PLUMBING PERMIT
Additional desc . .
Permit Fee . . . 62 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 12/11/13
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Other Fees . . . . . . . . . STATE PLBG DCA SURCHARGE 2 . 00
STATE PLBG DBPR SURCHARGE 2 . 00
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Fee summary Charged Paid Credited Due
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--- ------ ---------- ---------- ----------
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 ��J g
�i
JOB ADDRESS: 5029 FL ET 1 WJQ)AIG Li V0 A-rLA JTI C '6f7ACH PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value $GG-00
TYPE OF FIXTURE QTY TYPE OF FIXTURE 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
RE-PIPE:
TYPE OF FIXTURE QTY TYPE OF FIXTURE 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: gallons(Requires 3 sets of plans)
❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor (Trap) g
❑ Lawn Sprinkler System-Number of Heads
❑ Well **
** SJR WD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.**
❑ Pther
nce within a six month period or work is suspended or abandoned for six months.I hereby certify that I have read
Pei mit becomes void if work does not comme
is 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
this
The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of construction.
or
Property Owners Name Dolores f�5�P+� �e NA R� _Phone Number
X44— 5-1-3(o`�ocl- 9 z�a_'P -9z
Plumbing Company n FFA
Office Phone 2-102-0191 Fax
R DA pi LE �NA'T£2 �.L Zip 32..25
Co. Address: 3760 K o R i 120A Cityc KS flU �e State
License Holder Print): i�A R State Certification/Registration# 0�a S
Notarized Signature of License Holder �Z��% C. 1
Notary Public Stela of Florida
Sworn and subscribed bef e this day of 20
Dorothy M Devore
My Commission EE 854361 Signature of Notary P lic
OF Expires 02/09/2017