440 Osprey Key 2013 Plumb 1r�
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
011 a?
Application Number . . . . . 13-00003830 Date 12/12/13
Property Address . . . . . . 440 OSPREY KEY
Application type description PLUMBING ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
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Application desc
10 FIXTURES
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Owner Contractor
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JACKSON EDMUND W JR HOFFMAN PLUMBING II INC.
440 OSPREY KEY CHRISTOPHER E HOFFMAN
ATLANTIC BEACH FL 322334367 P.O. BOX 65058
ORANGE PARK FL 32065
(904) 282-9433
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Permit . . . . . . PLUMBING PERMIT
Additional desc . .
Permit Fee 125 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 6/10/14
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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 125 . 00 125 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 129 . 00 129 . 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: —V0�:( 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 _J — Shower --
Dishwasher Shower Pan
Slop Drinking Fountain Sp 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 **
** SJR WD 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
p anFi y of construction.
or not. The permit does not give authority to violate the provisions of an other sta or 1 IIJJ
Property Owners Name C Phone Number
Plumbing Company In Office Phone Fax
Co. Address: 3°►IV �4t/GAr4n City , State_ Zip 3 i 0 6S
License Holder(Print): S /t S ate Certification/Registration# CFC,112-7111
5-4,
Notarized Signature of License Holder
JENNIFERWALM(E�R' Before me this 1-day of - / 20�3
. MY COMMISSION#FF
: ,:, EXPIRES:April 24,2017 Signature of Notary Public
Bonded Thu Notary Public Underwriters