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178 Pine St 2014 plumb repipe its CITY OF ATLANTIC BEACH J 800 SEMINOLE ROAD •j � ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 ht Application Number . . . . . 14-00000476 Date 3/28/14 Property Address . . . . . . 178 PINE ST Application type description PLUMBING ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 Owner Contractor _ _ ------------------------ JONES, RUSSELL A & ELIZABETH WILLIAM' S BIG BOY PLUMBING INC 380 GARDEN LANE 516 SOUTH 11TH AVE ATLANTIC BEACH FL 32233 JACKSONVILLE BEACH FL 32250 (904) 241-1880 ------------------------------------------ Permit . . . . . . PLUMBING PERMIT Additional desc . . . 00 Permit Fee . . . . 125 . 00 Plan Check Fee Issue Date . . . . Valuation . . . . 0 Expiration Date . . 9/24/14 --------------------- ----------------------------- Other Fees . . . . . . . . . STATE PLBG DCA SURCHARGE 2 . 00 STATE PLBG DBPR SURCHARGE 2 . 00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- -- Permit Fee Total 125 . 00 125 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 129 . 00 129 . 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 JOB ADDRESS: Pkr- Q (% - PERMIT# 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 ? Hose Bibs 1 Urinal Kitchen Sink Vacuum Breakers Laundry TrayWater 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 **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 d� ``100V?5 rel Phone Number Plumbing Company W c1�t LZI, �9 t 6w Office Phone 2 qt— ** Fax Co. Address: 5- 1 �'�V�� City Jaw 6,L. State 7 Zip 322S Z? License Holder(Print): I l� �• LIw State Certification/Registration#�t'�LP/p70 Notarized Signature of License Holder Before me this qday of elK 20 Signature of Notary Public Ink