1929 Seminole Rd 2013 repipe CITY OF ATLANTIG BEACI
r j 800 SEMINOLE ROAD
J ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 13-00003426 Date 9/18/13
Property Address . . . . . . 1929 SEMINOLE RD
Application type description PLUMBING ONLY
Property Zoning . . . . . . . RES GEN MF DISTRICT
Application valuation . . . . 0
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Application desc
11 FIXTURES
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Owner Contractor
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LAMBERT, MARK S RINKWELL PLUMBING INC
1929 SEMINOLE ROAD 5105 PHILIPS HIGHWAY 205
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32217
(904) 732-5554
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Permit . . . . . . PLUMBING PERMIT
Additional desc . .
Permit Fee . . . . 132 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 3/17/14
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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 132 . 00 132 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 136 . 00 136 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
10 CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph (904) 247-5826 Fax (904) 247-5845
JOB ADDRESS: �►a� -rift ; o I QA Pf+Iaiu�i lip a-ek 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
-PIPE.
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub f 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
Lavatory0/ /
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 MW bkli�. "II,6`°`-i Phone Number
Plumbing Company Rte:�,� : -, (?al - - Office Phone���1=13��5�%
Co. Address: (oL5aCity Statev�azip —
License Holder(Print):
State Certifi ti egistration#CSC`Qa15-a
Notarized Signature of License Holder
BEVERLY D.FUNK Sworn d s scribed before me this day of 201
MY COMMISSION#EE 150684
* * ly 1 CJl�wv
EXPIRES:April3,2016 Signature of Notary Public
^�lFOF FI�Q�� BmW Thru W"