2212 Laughing Gulll 2013 Plumb CITY OF ATLANTIC BEACH
s j 800 SEMINOLE ROAD
J
V� ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Application Number
13-00003357 Date 9/05/13
Property Address . . . . . . 2212 LAUGHING GULL CIR
Application type description PLUMBING ONLY
Property Zoning . . . . . . . RES SF DISTRICT
Application valuation . . . . 0
Owner Contractor
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--------------
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WALLACE RUTH N PLUMBING BY JOSH
5677 FLORAL AVE
2212 LAUGHING GULL CIR
JACKSONVILLE FL 32211
ATLANTIC BEACH FL 32233 (904) 745-3330
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Permit . . . . . . PLUMBING PERMIT
Additional desc . Plan Check Fee . 00
Permit Fee . . . . 90 . 00 0
Issue Date Valuation
Expiration Date . . 3/04/14
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----------------------------
2 . 00
Other Fees . . . . . . . . . STATE PLBG DCA SURCHARGE
STATE PLBG DBPR SURCHARGE 2 . 00
________ ------
Fee summary Charged
--Paid Credited ----Due---
----------------- ----------
----- . 00
90 . 00 . 00
Permit Fee Total 90 . 00 00 00 . 00
Plan Check Total • 0000 . 00 4 . . 00
Other Fee Total 4 . 00 00 . 00
Grand Total 94 . 00 94 . 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: 0 Cro 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:
:i Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor (Trap) gallons(Requires 3 sets of plans)
:i Lawn Sprinkler System-Number of Heads ❑ Well
�* SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection."
i Other
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
tis 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
r 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.
roperty Owners Name Phone Number
lumbing Company PJYMIJ 4Y ';JaS� � - Office Phone - &0 Fax
o. Address: S6 O City State Zi
icense Holder (Print): Atate Certification/Registration#c�cy�-3r�SC
otarized Signature of License Holder Lr--�-� k _ a
Sworn and subscribed before me this ��day of �' 20 3
JENNIFER WALKER
MY COMMISSION M FF 011480 Signature of Notary Public
; ` EXPIRES:April 24,1 2017
Bonded Thni Notary Pudic nderwriter