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683 Sturdivant Ave 2013 repipe R, x f CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD r) ATLANTIC BEACH, FL 32233 -r INSPECTION PHONE LINE 247-5814 J131��' Application Number . . . . . 13-00002998 Date 7/05/13 Property Address . . . . . . 683 STURDIVANT AVE Application type description PLUMBING ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc REPIPE 12 FIXTURES ---------------------------------------------------------------------------- Owner Contractor - ------------------------ ----------------------- KRITSKY, MARY ANN ET AL LARRY TEAGUE & SONS PLUMBING 128-7 SEMINOLE RD 203 OCEANFRONT ATLANTIC BEACH FL 322334154 NEPTUNE BEACH FL 32266 (904) 270-2289 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc . . Permit Fee . . . . 139 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 1/01/14 --------------------------------------------------------------------- Other Fees . . . . . . . . . STATE PLBG DCA SURCHARGE 2 . 09 STATE PLBG DBPR SURCHARGE 2 . 09 ----------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- --------- Permit Fee Total 139 . 00 139 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 4 . 18 4 . 18 . 00 . 00 Grand Total 143 . 18 143 . 18 . 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 v� Ph(904) 247-5826 Fax(904) 247-5845 f� J Ql JOB ADDRESS: (� -�v r�d► dQ�l� �t-r-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 Other Fixtures Water Treating System RE-PIPE: TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY Bathtub / Septic Tank&Pit Clothes Washer T— Shower Dishwasher _�_ Shower Pan Drinking Fountain Slop Sink Floor Drain Three Compartment Sink Floor Sink Toilet 1 Hose Bibs Urinal Kitchen Sink 1 Vacuum Breakers Laundry Tray Water Connected Appliances Lavatory x 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 rnty to vio at the wgviisssiio�of any other state or local law regulation construction or the performance of construction.. Property Owners Name lam' —J Phone Numbe 0 ��113 Plumbing Company L�f _Office Phone a A % —F Co. Address: D5 City 19 - te�Zip3 License Holder(Print): Ar nD &22A fl State Certification/Registration# Notarized Signature of License Holder r MELANIE A.DARLINGTON Sworn and subscribed befor me this day f JV 20 13 MY COMMISSION EE19>l733 ". . EXPIRES May 15.sold Signature of Notary Public CL ;.0