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700 Triton Rd 2014 Plumb CITY OF ATLANTIC BEACH S 800 SEMINOLE ROAD J X ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 �Jl3c ? Application Number . . . . . 14-00000230 Date 2/21/14 Property Address . . . . . . 700 TRITON RD Application type description PLUMBING ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ------------------------------------------------ Application desc 7 FIXTURES ---------------------------------------------- Owner Contractor ------------------------ ------------------- LOPEZ IRIS M TRUST ALL PHASES PLUMBING 5824 REBA ST 865 SAILFISH DR MORTON GROVE IL 60053 ATLANTIC BEACH FL 32233 (904) 773-3985 ---------------------------------------------------- ----------------------- Permit . . . . . . PLUMBING PERMIT Additional desc . . . 00 Permit Fee . . . . 55 . 00 Plan Check Fee Issue Date . . . . 2/18/14 Valuation . . . . 0 Expiration Date . . 8/17/14 --------------------- --------------------------- Other Fees . . . . . . . . . STATE PLBG DCA SURCHARGE 2 . 00 STATE PLBG DBPR SURCHARGE 2 . 00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----- ---------- ---------- Permit Fee Total 55 . 00 55 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 59 . 00 59 . 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 - 45 JOB ADDRESS' ' C �tG� 3 2?3 PERMIT# NEW OR REPLACEMENT INSTALLATION: Project Value$J�ot� TYPE of FIXTURE QTY TYPE of FIXTuRE Qry 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 j Other Fixtures Water Treating System RE-PIPE: TYPE of F/XTURE 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: ❑Sewer Replacement ❑Back Flow Preventer ❑Grease Interceptor(Trap) gallons(Requires 3 sets of plans) ❑ Lawn Sprinkler System-Number of Heads ❑ Well " **SIRWD 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.1 hereby certify that 1 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 authonn'q to violate the provisions of any other state or local law regulation construction or the performance of construction. Property Owners Name /U`S Phone Number Company AA. cx��,��,,i-� Office Phone) d �Fax— Plumbing Co.Address: 1 Z5 �+t�i�rK�C Lit+` - City_jW aALJriL State J Zip X 33— License Holder(Print): State Certification/egistmtion# 11'G S Notarized Signature of License Holder A 004-0` Before me this ay of f�) 2 Mr ca►o essron#FF m1480 f j a„uE IREi+S: 244.20117 Signature of Notary Public a.,�..}