891 Plaza 2014 repipe CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 14-00000568 Date 4/14/14
Property Address . . . . . . 891 PLAZA
Application type description PLUMBING ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
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Application desc
5 fixtures
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Owner Contractor
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DAVIS, BEVERLY TDG PLUMBING
891 PLAZA 4426 LOYS DRIVE
ATLANTIC BEACH FL 322333809 JACKSONVILLE FL 32246
(904) 545-7341
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Permit . . . . . . PLUMBING PERMIT
Additional desc . .
Permit Fee . . . . 90 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 10/11/14
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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 90 . 00 90 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 94 . 00 94 . 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
(aq , Ph(904)247-5826 Fax (904) 247-5845
JOB ADDRESS: V-7/ PL':; -z"9 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 TrayWater 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 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 **
** SJR WD 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 work will be complied with whether specified
this application and know the same to be true and correct. All provisions of laws and ordinances governing
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 C<eye c Ll Oil J ' , Phone Number
Plumbing Company—; ` Office Phone,'57Y S''73�11 Fax! �H '1$S
Cit J x State�zip 3 y S-
Co. Address: ��� 1-0 y
Gz Qy 1 J �� A;rem/ State Certification/Registration#
License Holder(Print): 1 3
Notarized Signature of License Holde
efore me this�_day o 20
JENNIFER WALKER
sir r MY COMMISSION Y FF 011480 ignature of No 'Public
EXPIRES:April 24,2017
Bended Thru Notary Pubic Underxrders