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940 Sailfish Dr 2013 Plumb `s f CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD J - ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . 13-00003820 Date 12/11/13 Property Address . . . . . . 940 SAILFISH DR Application type description PLUMBING ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ------------------------------------------------------------------ Application desc 6 fixture replacement ------------------------------------------------------------------ Owner Contractor - ------------------------ ----------------------- ARCHIPELAGO IMMOBILIEN, LLC FAVOR PLUMBINGINC 1140 N 20TH ST 2606 KERSHAW DR W JACKSONVILLE BEACH FL 32250 JACKSONVILLE FL 32211 (904) 874-4266 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc . . Permit Fee 97 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 6/09/14 ------------------------------------------------------------ Other Fees . . . . . . . . . STATE PLBG DCA SURCHARGE 2 . 00 STATE PLBG DBPR SURCHARGE 2 . 00 ----------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- -- Permit Fee Total 97 . 00 97 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 101 . 00 101 . 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 JOB ADDRESS: 1 40 .541I_jP71 S 0 r2 1.J PERMIT # NEW OR REPLACEMENT INSTALLATION: Project Value$ 966 at 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 I 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 **SIRWD 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 Phone Number Plumbing Company ��wa 2 P �. vim e-!-r•'� Office Phone 'IN-M-OI" Fax J Co. Address: �60(0 X q-4stM�t-W 04- L,J City tr7t_ State IPL- Zip 3221 / License Holder(Print): N 1 Et- 1 i e-4 ZC- State Certification/Registration# (5-FGr� t gynar Notarized Signature of License Hol e =UnderwrRem efore me this day 2 7 e1;M..Y• �. SHI *; ►:• i;OM60 APART14 ignature of Notary Public 3onded Thru wrfters r 1