1827 Ocean Grove Dr water softnr 2013 v
CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
!� ti ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
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Application Number . . . . . 13-00002974 Date 6/28/13
Property Address . . . . . . 1827 OCEAN GROVE DR
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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COUGHLIN KELI A & AFFORDABLE WATER/KINDER INC
JOYCE CHRISTOPHER J. 3760 KORI ROAD
1827 OCEAN GROVE DR JACKSONVILLE FL 32257
ATLANTIC BEACH FL 32233 (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 . . 12/25/13
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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
----------------- ---------- ---------- ---------- ----------
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
JOB ADDRESS: 162.1 OCEAN Gizo-4F_ 'D&601E AILCIAL jLh _PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value $ &G -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 01
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
I`ermit 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
her specif
rhis application and know the same to b to and violate the provisions sons of any other state or local lawrovisions of laws and ordinances regu atilonthis work construction lbe complied with or the performance of constructional
carr not. The permit does not gree authorityp 9u4 �12—rJ y 5q
Property Owners Name C-N psi o P hE2 � �E G 'Jay CE _Phone Number _
FFoR p -- �q•j'-�( OfficePhone�t�2-01`��I Fax o� ��_�zgz
Plumbing Company /� �. p 32.25
Co. Address: 3 r�G�0 k
o K + 'ROAD . . City �cKS L n� le State Zi
State Certification/Registration# 000 8 18 6
License Holder(Print):
Notarized Signature of License Hotder J: 'l2'�G��C �� �G,
Notary Public state of Florida Sworn and subscribed bef e this day of
20 13
Dorothy M Devore
My Commission EE 854381 Signature of Notary P lie
pf Expires 02/0912017