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
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Application desc
8 fixtures
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-- ----------------------------------------------------------
Owner Contractor
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------------------------
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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
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Permit . . . . . . PLUMBING PERMIT
Additional desc . Plan Check Fee . 00
Permit Fee . . . . 111 . 00 0
Issue Date Valuation
Expiration Date . . 3/25/14
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----------------------------
2 . 00
Other Fees . . . . . . . . . STATE PLBG DCA SURCHARGE
STATE PLBG DBPR SURCHARGE 2 . 00
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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�