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1735 Seminole Rd 2013 water heater J CITY OF ATLANTIC BEACH Vis) 800 SEMINOLE ROAD J " ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 �JA Application Number . . . . . 13-00003273 Date 8/16/13 Property Address . . . . . . 1735 SEMINOLE RD Application type description PLUMBING ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ------------------------------------------ Application desc water heater ------------------------------------------ Owner Contractor ---------------- _ ------------------------ VENN, JEFFREY E DAVID GRAY PLUMBING INC. 1735 SEMINOLE ROAD 6491 POWERS AVENUE ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32217 (904) 724-7211 --------------------------------------- Permit PLUMBING PERMIT Additional desc . . . 00 Permit Fee . . . . 62 . 00 Plan Check Fee Issue Date . . . . Valuation . . . . 0 Expiration Date . . 2/12/14 ------------------------------ 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 Beac]:, FL 32233 Ph (904)247-5826 Fax(904)247-5845 JOB ADDRESS: �� f�o�f 0/}t? PER1vIIT# NEW OR REPLACEMENT INSTALLATION: Project Value$ TYPE OF FLUURE OTY TYPE OFFtxTURE 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 i Lavatory Water Heater Other Fixtures Water Treating System RE-PIPE: TYPE OF FMTURE QTY TYPE OFFIXTURE QTY Bet tub 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 I'vHSCETLLANEOUS: ❑ Sewer Replacement ❑ Back Flow Preventer :1 Grease Interceptor (Trap) gallons(Requires 3 sets of plans) ❑ Lawn Sprinkler System-Number of Heads ❑ Well ** • ** SIRWD 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 saint to be true and correct All provisions of laws and ordinances governing this work will be complied with whether specified �r not The permit does not give aut3ority t9�violate the p isions of am other state or local-law regulation construction or the performance of construction. Property Owners Name I f e'-� �i>l� Phone Number ��y ��4 1 Plumbing Company DAVID GRAY PLUMBING, INC. Offtce Phone 724-7211 Fax Co.Address: 6491 Powers Avenue Cid, Jacksonville, FL 32217 License Holder (Print): David F. Gray State Certificaticn/Registration# M0225-86 Notarized Signature of License Holder Sworn and subscribed before me L., y of 201L Signature of Notary Public l L•d 9999 9ZL V06 ONISAnld X"O 01AVC] 9L Env