850 Seminole Rd 2014 (fire dept) water heater CITY OF ATLANTIC BEACH
s f 800 SEMINOLE ROAD
J
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
JJ
14-00000090 Date 1/22/14
Application Number g50 SEMINOLE RD
Property Address • • • • ' FIRE DEPARTMENT
Tenant nbr, name . . . . .
Application type description PLUMBING ONLY
Property Zoning . . . . . . . RES SF DISTRICT
Application valuation . . . . 0
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Application desc
REPLACE WATER HEATER
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Contractor
Owner
---------------
OF ATLANTIC BEACH ASAP PLUMBING & DRAIN CLEANIN
CITY SOF ATLANTIC
TI SD SERVICES OF JACKSONVILLE
800
P. O. BOX
ATLANTIC BEACH FL 32233
JACKSONVILLE
FL 32245
(904) 994-6440
-----------------------------
Permit . . . . . . PLUMBING PERMIT
Additional desc . Plan Check Fee . 00
Permit Fee . . . . 62 . 00 0
Issue Date Valuation
Expiration Date . . 7/21/14
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-----
------------------------
2 . 00
Other Fees . . . . . . . . . STATE PLBG DCA SURCHARGE
STATE PLBG DBPR SURCHARGE 2 . 00
Fee summary Charged
Paid Credited
----------
----------
- ---- 62 . 00 62 . 00 . 00
Permit Fee Total 00 00 . 00
Plan Check Total • 00 . 00
00 . 00 4 .
Other Fee Total 4 . 00 00 . 00
Grand Total 66 . 00 66 . 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
�} PERMIT# /
JoB ADDRESS: > <p/"
NEW OR REPLACEMENT INSTALLATION: Project Value$ d
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: gallons(Requires 3 sets of plans)
❑ Sewer Replacement ❑ Back Flow Preventer ii Grease Interceptor(Trap) g 9
❑ Lawn Sprinkler System-Number of Heads
❑ Well **
** S,IRWD 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 NameG i T� o u AckSO,�I/r.�L
Phone Number
Plumbing Company f S/�/° �1k� "' Office Phone
o X �®7� City h`� State Zip 3
-,,7,7117
Co. Address:
�'��'
State Certification/Registration#
License Holder (Print): GG oS�GS7
Notariz r
•i�`Y a`• SHIRiEY L GRAHAM (1 Of 2
_a ,r
AY COMMISSION#DD 957760$ ore me this
EXPIRES:February 14,2014
pF ,, Sononded Thru Notary Public Underwrite nature Of Notary P lc