620 W Dutton Island Rd 2013 plumb t r, CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
vJl� J�
Application Number . . . . . 13-00003826 Date 12/12/13
Property Address . . . . . . 620 W DUTTON ISLAND RD
Application type description PLUMBING ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
----------------------------------------------------------------------------
Application desc
7 fixtures
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
HAMM, JAMES MARTIN JR ADVANTAGE PLUMBING
PO BOX 1696 880 MAYPORT RD
PONTE VEDRA BEACH FL 320041696 P.O. BOX 49225
JACKSONVILLE BEACH FL 32240
(904) 247-9848
----------------------------------------------------------------------------
Permit . . . . . . PLUMBING PERMIT
Additional desc . .
Permit Fee . . . . 111 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 6/10/14
----------------------------------------------------------------------------
Other Fees . . . . . . . . . STATE PLBG DCA SURCHARGE 2 . 00
STATE PLBG DBPR SURCHARGE 2 . 00
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 111 . 00 111 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 115 . 00 115 . 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
.TOB ADDRESS: V(�( l& �� 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 Shower
Dishwasher Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry TrayWater Connected Appliances
Lavatory _LU;_ Water Heater
Other Fixtures Water Treating System
MISCELLANEOUS: )
❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor (Trap) gallons(Requires 3 sets of p
❑ Lawn Sprinkler System-Number of Heads
❑ Well **
** SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspectio
❑ 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 haved
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 specs
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 constructs
M a rh iA l J a �� Phone Number
Property Owners Name
Plumbing Company
�� P�(,clYt Office Phone g Fax
City , State � Zip
Co. Address: /
License Holder(Print): Y 67-It'�s Stat ertifi n/Registration#
Notarized Signature of License Holder
:'y•. JUUE YOUNG CHRISn"
i Sworn and subscrib d b e me this�day of 20
MY COMMISSION#FF OO�2
y Signature of Notary Public
�•: EXPIRES:Jul 2t,2017
SRFd Bonded Thru Notary Public Underwriters
OQ��