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1865 Hickory Ln 2014 repipe CITY OF ATLANTIC BEACH J 800 SEMINOLE ROAD s) ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 C !tit Application Number . . . . . 14-00000614 Date 4/21/14 Property Address . . . . . . 1865 HICKORY LN Application type description PLUMBING ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ----------------------------------------------- Application desc 9 fixtures repipe ----------------------------------------------- Owner Contractor ---------- - - - ------------------------ ------ - --- CAMPBELL, WALTER & LEA ANNE AMERICAN PLUMBING CONTRACTORS 1865 HICKORY LANE 5720 ARLINGTON RD ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32211 (904) 591-5380 -------------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc . . . 00 Permit Fee . . . . 118 . 00 Plan Check Fee Issue Date . . . . Valuation . . . . 0 Expiration Date . . 10/18/14 --------------------- ---------------------------- Other Fees . . . . . . . . . STATE PLBG DCA SURCHARGE 2 . 00 STATE PLBG DBPR SURCHARGE 2 . 00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- -- Permit Fee Total 118 . 00 118 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 122 . 00 122 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. Ap r. 21. 2014 8 : 17AM No. 0130 P. 1 PLUMBING PFRMYT APPLICATION I CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach,FL 32233 I Ph(904)247-5826 Fax(904) 247-5845 �?3 1 PERMIT# �oia ADDRF-ss: /i? 14EW OR REPLACEMENT INSTALT-ATION: Project Value$ TYPE'of FEaVAR QTY TYPE of FixTuRE QTY Septic Tank&Pit Bathtub —1 Shower Clothes Washer Shower pan Dishwasher Drinking Fountain Slop Sink Floor Drain. _ Three Compartment Sink Toilet Floor Sink Urinal —�— Hose Bibs Vacuum Breakers Kitchen Sink Water Connected Appliances Laundry Tray Water Heater —�- Lavatory Water Treating System Other Futures E2T;-PTFE: TYPE of F7xTURE Qry TypE oFFixTuRE QTY Bathtub ( Septic Tank&Pit - Shower Clothes Washer Shower Pan Dishwasher Slop Sink Drinking Fountain - Three Compartment Sink Floor Drain r Toilet Floor Sink �� Urinal Idose Bilis Vacuum Breakers Kitchen Sink Water Connected Appliances Laundry TIAY Water Heater --- Lavatory Water Treating System �-- other Futures MISCELLANEOUS: ( p)� allorls(Requires 3 sets of plans) D Sewer Replacement ❑Back Flow Preveuter ❑ OTease Interceptor Tra g D Lawn Sprinkler System-Number of Heads ❑ Well ent for final inspection-** *;. ,SJ"RWD Well Completion Form. Completed form.to be,submitted to the Building Departm Other at Ili avo Permit becomes void if work does not commence witbin a six month periodof lawsoand ordinances govern g th73 ins WOrk will be co plied with hcetther specified this applioation and know the Seine to be true and correct. All provisions or not. The permit does not give authority to violate the provisions of any other state or local law regulation construction or thehe r£armance o construction- 0 phone Num (0 property Owners Namo Office Phone Plumbing CompanyfiState �`Z, zip � City >+� - Co. Address; istratio" tate Cei�tifica a/l�eg License Holder (Print): Notarized Sxgit ature of Lke [der 20� efo. day KIM I,ASSI (n+;lrE= d Sub •7late 01 Fonda Notary Pu * .= My Comm.Expos ASS of otary public l;ommisslon#�E 17 y� ^