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329 11th St 2014 water softner CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD j y ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 14-00000199 Date 2/10/14 Property Address . . . . . . 329 11TH ST Application type description PLUMBING ONLY Property Zoning . . . . . . . RES SF LRG-LOT DISTRICT Application valuation . . . . 0 ------------------------------------------------------------ Application desc WATER SOFTNER --------------------------------------------------------- Owner Contractor - ------------------------ ----------------------- HAYES, JARROD AFFORDABLE WATER/KINDER INC 329 11TH STREET 3760 KORI ROAD ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32257 (904) 262-0197 ------------------------------------------------------ Permit PLUMBING PERMIT Additional desc . . Permit Fee 62 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 8/09/14 ---------------------------------------------------- Other Fees . . . . . . . . . STATE PLBG DCA SURCHARGE 2 . 00 STATE PLBG DBPR SURCHARGE 2 . 00 --------------------------------------------------- Fee summary Charged Paid Credited ----Due--- ----------------- ---------- ---------- ------ Permit Fee Total 62 . 00 62 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 66 . 00 66 . 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 q Jos ADDRESS: T N RE-E-7- A-rLRA(riC BCAgCd fl- JOB L rERMrr fv6 .UO NEW OR REPLACEMENT INSTALLATION: Project TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY Septic Tank& Pit Bathtub Shower Clothes Washer Shower Pan Dishwasher Slop Sink Drinking Fountain Three Compartment Sink Floor Drain Toilet Floor Sink Urinal Hose Bibs Vacuum Breakers Kitchen Sink Water Connected Appliances Laundry Tray Water Heater Lavatory Water Treating System — �— Other Fixtures RE-PIPE: TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY Septic Tank& Pit Bathtub Shower -- Clothes Washer Shower Pan Dishwasher ---- Slop Sink -- Drinking Fountain Three Compartment Sink _--- Floor Drain Toilet Floor Sink Urinal -- Hose Bibs Vacuum Breakers Kitchen Sink Water Connected Appliances Laundry Tray Water Heater — 4 Lavatory Water Treating System — Other Fixtures MISCELLANEOUS: allons(Requires 3 sets of plans) ❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor (Trap) **g ❑ Well ❑ Lawn Sprinkler System-Number iof Heads__ ** Complete form to be submitted to the Building Department for fi SJRWD Well Completionnal inspection.* ❑ Other a laws and ordinances governing this work will be complied with e fether suction d Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months.I herebycertifythat 1 have read cons this application and know the same to be true and correct. All provisions of Z l 5 7 j Z or not. The permit does not give authority to violate the provisions of any other state or local law regulation construe Number 3 A Y>� Phone qo Property Owners Name J r r�� �o�(- Fax zoo-4p 2.9 z D FG"�a n o n, i -IZ _Office Phone Plumbing Company KSn nv ��2 State�L Zip 3 225 oR j 1�0�i City Co. Address: 3'76 K OCY� 18�o State Certification/Registration# License Holder (Print): 77 ' Notarized Signature of License Hotder da of Fe b r u a n 20 y e of Fbnde Sworn and subscribed bef e this � Y re lic REM E 854361 Signature of Notary P17