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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 ---------------------------------------------------------------------------- Application desc water softner ---------------------------------------------------------------------------- Owner Contractor - ------------------------ ----------------------- 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 ------------------------------------------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc . . Permit Fee . . . 62 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 12/11/13 ------------------------------------------------------------------ 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 ��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