Loading...
28 17th St 2014 repipe CITY OF ATLANTIC BEACH J 800 SEMINOLE ROAD .J Aye ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 14-00000162 Date 2/04/14 Property Address . . . . . . 28 17TH ST Application type description PLUMBING ONLY Property Zoning . . . . . . . RES GEN 2F DISTRICT Application valuation . . . . 0 ------------------------------------------- Application desc repipe ----------------------------------------- Owner Contractor ------------------------ GAY CATHY PROFESSIONAL PLUMBING SERVICES 28 17TH ST ATLANTIC BEACH FL 322335810 ATLANTIC BEACH FL 32233 -- ------------------------------------------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc . . . 00 Permit Fee . . . . 160 . 00 Plan Check Fee Issue Date . . . . Valuation . . . . 0 Expiration Date . . 8/03/14 ------------------------------- Other Fees . . STATE PLBG DCA SURCHARGE 2 .4 STATE PLBG DBPR SURCHARGE 2 .40 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ---------- Permit Fee Total 160 . 00 160 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 4 . 80 4 . 80 . 00 . 00 Grand Total 164 . 80 164 . 80 . 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: G s PERMrr#� 7 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 --29 Hose Bibs Urinal Kitchen Sink Vacuum Breakers Laundry TrayWater Connected Appliances Lavatory —� Water Heater Other Fixtures Water Treating System I 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 violate the provisions of any other state or local law regulation construction or the performance of construction. Property Owners Name,�1�N Q'� Phone Number Fax — Plumbing Plumbing Company / �6 �c s s�'o •� cl �'N4 Office Phone ,� /�� �r�,c State�� Zip 3 Z Z 2'.)Co. Address: Sr L- e"r /"04 R City . / 3�� z License Holder(Print): State Certification/Registration# GFc° Notarized Signature of License Holder Before me this day of 20 Signature of Notary Public