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1870 George St (1872) repipe 2013 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 13-00002929 Date 6/25/13 Property Address . . . . . . 1870 GEORGE ST Application type description PLUMBING ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc 8 fixtures ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ JACKSONVILLE HOUSING AUTHORITY A.D. I . SERVICES INC 1300 BROAD STREET 2749 ERNEST ST FL 32205 JACKSONVILLE FL 32202 JACKSONVILLE (904) 384-4433 ---------------------------------------------------------------------------- Permit PLUMBING PERMIT Additional desc . . Permit Fee . . . . 111 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . - 12/22/13 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . STATE PLBG DCA SURCHARGE 2 . 00 STATE PLBG DBPR SURCHARGE 2 . 00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 111 . 00 111 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 115 . 00 115 . 00 . 00 . 00 PERMIT IS APPROVED ONLV IN ACCORDANCE WITH ALL CITV 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 JoB ADDRESS: 7� 6r -J- PERMIT# NEW OR REPLACEMENT INSTALLATION: Project Value $ TYPE oF FixTuRE Q7T 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-PIEPE: 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: F-i Sewer Replacement o Back Flow Preventer F-i Grease Interceptor(Trap) gallons(Requires 3 sets of plans) Ei Lawn Sprinkler System-Number of Heads [:i Well **,VRWD Well Completion Form. Completed form t be submitted to the Building Department for final inspection." Ei 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. e &1Jrff12AttY Phone Number Property Owners Nam Office Phone 33q-q Y 3 Fax 36Y 169'? Plumbing Company A V1 C f-5 City �-4ty-50J Vlkj,�- State Zip3 2-2 e5 Co. Address: 5r— 54- License Holder(Print): 0-�J[A'15 K, YhEA10L-5tate Certification/Registration 4 46-oWh?7 3 Notarized Signature of License Holder ULuAN c surm 5worn and subscribed before this dayof-, �Ilh �- 20 A A my commsem#EV51M 5ignature of Notary Public Comm iNvow 08 .2016 �!Ubl I CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 r Application Number . . . . . 13-00002930 Date 6/25/13 Property Address . . . . . . 1870 GEORGE ST Tenant nbr, name . . . . . . UNIT 1872 Application type description PLUMBING ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc repipe 8 fixtures ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ JACKSONVILLE HOUSING AUTHORITY A.D. I . SERVICES INC 1300 BROAD STREET 2749 ERNEST ST JACKSONVILLE FL 32202 JACKSONVILLE FL 32205 (904) 384-4433 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc . . Permit Fee . . . . 111 . 00 Plan Check Fee . 00 Issue Date . . . . valuation . . . . 0 Expiration Date . . 12/22/13 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . STATE PLBG DCA SURCHARGE 2 . 00 STATE PLBG DBPR SURCHARGE 2 . 00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 111 . 00 111 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 115 . 00 115 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITV 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 JoB ADDRESS: Z, 61g a-ri.),5- S'�� PERMIT# NEW OR REPLACEMENT INSTALLATION: Project Value TYPE oF FixTuRE QTY TYPE oF FinvRE 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-PIEPE: TYPE OF FIXTURE QTY TYPE oF FixTuRE QTY Bathtub Septic Tank&Pit Clothes Washer Shower Dishwasher Shower Pan Drinking Fountain Stop Sink Floor Drain Three Compartment Sink Floor Sink Toilet Hose Bibs I Urinal Kitchen Sink I — Vacuum Breakers Laundry Tray Water Connected Appliances Lavatory 2, Water Heater Other Fixtures Water Treating System MISCELLANEOUS: [:i Sewer Replacement El Back Flow Preventer Ei Grease Interceptor(Trap) gallons(Requires 3 sets of plans) E Lawn Sprinkler System-Number of Heads Ei Well **SJRWD Well Completion Form. Complete&-form to be submitted to the Building Department for final inspection." o 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 Plumbing Company Office Phone Fax Co. Address: city State—Zip License Holder(Print): State Certification/Registration# Notarized Signature of License older LILLIAN C SMITH 'Swom and subscribed befio;re jthnis, duay of 20 MY COMMMM 0 EEMM ExpRESjwWwyos.2016 Signature of Notary Publi