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45 Donner Rd 2013 water heater CITY OF ATLANTIC BEAQx. 1 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 13-00003401 Date 9/12/13 Property Address . . . . . . 45 DONNER RD Application type description PLUMBING ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc WATER HEATER ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ HILL JOHN W & MATTIE MAE DONALD CARTER PLUMBING INC 45 DONNER ROAD P O BOX 735 ATLANTIC BEACH FL 322334208 CALLAHAN FL 32011 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc . . Permit Fee . . . . 62 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 3/11/14 -------------------------------------------------------------------------- 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 Beach, FL 32233 Ph(904) 247-5826 Fax (904)247-5845 .TOB ADDRESS: V .5— � O ^i oc-3 e� a r� 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: ❑ 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 authority to violate the provisions of any other state or local law regulation construction or the performance of construction. Property Owners Name /,(, t L Phone Number Cl d L/'��l �/6 J^11 Plumbing Company Do,& C, . �-� w Q a , Office Phone Fax Co. Address: 4 ( 3 a..,r!l kryo City �'r( (�-1ti e.�,, State fJ—Zip 3 2-0 License Holder(Print): to Certification/Registration#C 1-Gb J 7 76 Notarized Signature of License Holder " VICKIE L.NIT@V ,T subscribed bef roe e this y,of M6Q)( 20� '01.14P`•�; Public StaYYe of . Notuy My Comm.ExD1feSn 2a, ore f Notary Public _. Commission# �Nt �'•: a�• ','� gpnW Tlsoigh National Notary Assn.