685 Amberjack Ln 2013 water heater CITY OF ATLANTIC BEACH
J 800 SEMINOLE ROAD
r� ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 13-00002881 Date 6/14/13
Property Address . . . . . . 685 AMBERJACK LN
Application type description PLUMBING ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
-------------------------------------------
Application desc
water heater
-------------------------------------------
Owner Contractor
-
------------------------
-----------------------
HALL COY LEE ADVANTAGE PLUMBING
685 AMBERJACK LANE 880 MAYPORT RD
ATLANTIC BEACH FL 322334202 P.O. BOX 49225
JACKSONVILLE BEACH FL 32240
(904) 247-9848
-- -------------------------------------------------------------------------
Permit . . . . . . PLUMBING PERMIT
Additional desc . . 00
Permit Fee . . . . 62 . 00 Plan Check Fee
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 /3 �Z
Ph(904)247-5826 Fax(904) 247-5845 fool
JOB ADDRESS: �� ZJ/--)1 4- .o C �' PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$
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 _L—
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:
❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
❑ 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 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 Phone Number
t
Plumbing Company .tet�l r+ Office Phone q 7-Jf1`/� Fax
Ci � State zip3z Z3�
Co. Address: /� `
License Holder(Print): L7 State Certi c on/Registration# /
Notarized Signature of License Holder
4
POP� Notary =::)"n
Sworn and subscribe b re me this day of _20
Jennife
c My ComSi afore of Notary blitNOFExpires