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4516 Polaris Ct 2013 repipe CITY OF ATLANTIC BEACH SS y 800 SEMINOLE ROAD r� ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 Application Number 13-00003451 Date 9/26/13 Property Address . . . . . . 1 FLEET LANDING BLVD MAIN Tenant nbr, name . . . . . . 4516 POLARIS CT Application type description PLUMBING ONLY Property Zoning . . . . . . . PLANNED UNIT DEVELOPMENT Application valuation . . . . 0 ------------------------------- Application desc 8 fixtures -------------- -- ---------------------------------------------------------- Owner Contractor -------------- ------------------------ ---------- NAVAL CONTINUING CARE LARRY TEAGUE & SONS PLUMBING F 203 OCEANFRONT FLEET LANDING 1 FLEET LANDING BOULEVARD NEPTUNE BEACH FL 32266 ATLANTIC BEACH FL 32233 (904) 270-2289 ------------------------------ Permit . . . . . . PLUMBING PERMIT Additional desc . Plan Check Fee . 00 Permit Fee . . . . 111 . 00 0 Issue Date Valuation Expiration Date . . 3/25/14 ----------- ---------------------------- 2 . 00 Other Fees . . . . . . . . . STATE PLBG DCA SURCHARGE STATE PLBG DBPR SURCHARGE 2 . 00 -------_--------------------------------------------- Fee summary Charged Paid Credited _ ------- . 00 ----- ---------- - . 00 Permit Fee Total 111 . 00 111 . 0000 00 . 00 Plan Check Total • 00 . 00 4 . 00 4 . 00 . 00 Other Fee Total 00 . 00 Grand Total 115 . 00 115 . 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 h(904)247-5826 Fax(904)247-5845 fa*; PERMIT# Jos ADDRESS' 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 vi to the provision of any other state or local law regulation construction or the performance of construction. Phone Number Ca/ Property Owners Name r �� ` 91 Q_),� Fax 'Q"D q Co. Address: Plumbing Company �r �Sd Office Phone n� O City n State Zip !—� I • License Holder(Print) a m-rl l State Certification/Registration# Notarized Signature of License Holder, A2 ,k/ MELANIE A.DARLINGTON _ da of 20 ' Sworn and subscribed befo me this Y -• ': MY COMMISSION*EE 198733 EXPIRES May 15,2018 Signature of Notary Public �o �ee.ots�