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2058 Beach Ave 2013 Plumb CITY OF ATLANTIC BEACH l 800 SEMINOLE ROAD s) ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 13-00002954 Date 6/26/13 Property Address . . . . . . 2058 BEACH AVE Application type description PLUMBING ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc SHOWER PAN ---------------------------------------------------------------------------- Owner Contractor - ------------------------ ----------------------- WAGONER LARRY D & JANELLE D EAGERTON PLUMBING CO. 2058 BEACH AVE 1093 N. MCDUFF ATLANTIC BEACH FL 322335935 JACKSONVILLE FL 32205 (904) 388-0761 --------------------------------------------------------------------------- Permit PLUMBING PERMIT Additional desc . . Permit Fee . . . . 62 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 12/23/13 --------------------------------------------------------------------- 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 CITU OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. PLUMBING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach, FL 32233 Z Ph(904) 247-5826 Fax (904) 247-5845 JOB ADDRESS: c;�05_ /B Pa chi Xe 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 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 tobesubmitted to the Building Department for final inspection.** ❑ Other toer 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 �4rr Phone Number Plumbing Company��� on t'� ffi wk �'�- Oce Phone L3g g 07� Fax 3�83G97 p Co. Address: 103 4/ Ol e z)i�41 A" City State !"TL Zip 3ZZsy License Holder (Print): IwmEFS G State Certification/Registration#cKI�Fb230q Nota is fel hr �0 r ;��' - MY COMMISSION#DD 957760 Lam'* fore me thisg?& day z 20 _ EXPIR�NF�P�CI ilndd 14 Signature of Notary Publi - 5 i�� - �