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
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Application desc
WATER SOFTNER
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Owner Contractor
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HAYES, JARROD AFFORDABLE WATER/KINDER INC
329 11TH STREET 3760 KORI ROAD
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32257
(904) 262-0197
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Permit PLUMBING PERMIT
Additional desc . .
Permit Fee 62 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 8/09/14
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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 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-
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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