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870 SEminole Rd 2014 Plumb repipe �s, CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD j ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 r !tit Application Number . . . . 14-00000686 Date S/01/14 Property Address . . . . . . 870 SEMINOLE RD Application type description PLUMBING ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 --------------------------------------------------------------- Application desc repipe 12 fixtures ------------------------------------------------------------ Owner Contractor - ------------------------ ----------------------- MIDGETT, CLAUDE E ATLANTIC COAST PLUMBING CORP. 870 SEMINOLE ROAD 3653 REGENT BLVD #30S ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32224 (904) 249-5381 ------------------------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc . Permit Fee 139 . 00 Plan Check Fee 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 10/28/14 --------------------------------------------------- Other Fees . . . . . . . . . STATE PLBG DCA SURCHARGE 2 . 09 STATE PLBG DBPR SURCHARGE 2 . 09 ------------------------------------------------- Fee summary Charged Paid Credited ----Due--- ----------------- ---------- ---------- ----- Permit Fee Total 139 . 00 139 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 4 . 18 4 . 18 . 00 . 00 Grand Total 143 . 18 143 . 18 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WIT14 ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. May 01 14 12: 23p Susan Parrish 904-246-3673 p. 1 PLUMBING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach,FL 32233 Ph(974)247-5826✓Fax(904)247-5845 PFJMIT ,IOB ADDRESS: �.- NEW OR REPLACEMENT ItNS'l;kLLATION: Project Value S 1 SPE OF FIxrURE QTY TYPE of FlxruRE Qr.Y Bathtub Septic Tank&Pit __ _— Clothes Washer Shower Dishwasher Shower Pan DrinkinFountain Slop Sink g -- Floor D9 Three Compartment Sink Floor Sink 'Toilet f lose )Sibs Urinal --- Kitchen Sink Vacuum Breakers Water Connected Appliances Laundry Tray • LWater Heater Lavatory ------ �- "Other Fixtures Water Treating System � 1 RIE-PIPE:/ / TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY Bathtubt Septic Tank& Pit Clothes Washcr —T! Shower — f — Dishwasher ! Shower Pan --- DrinkinFountain Stop Sink g Floor D9 Three Compartment Sink G Toilet Floor Sink -- ilose Bibs — Urinal ----- Sink t Vacuum Breakers Kitchen Sin _-- Laundry cherSi k Water Connected Appliances - Water Neater Lavatory Y _ Other Fixtures Water Treating System j 1 l�1 MISCELLANEOUS: allons (]Requires 3 sets of plans)Sewer Replacement © Back Flow Preventer ❑ Grease Interceptor(Trap) l; C] Lawn Sprinkler System-Number of Heads o WeII '` **SJRWD Wi,11 Complerion Form. Completed ion n to be submitted to the Building Department f�r final inspection.** O Other Permit hccome5 void if work doex not commence within a sic nionrb period or work is su.pcnded or abandoned for six n,ondts,l hereby cen ify that l have read All te corritt;ed with'"he"PcCifled his application a'+dknow daes notdie same Ed he true ioutlwrity Lo v olacc I+t provisionsect. �oi any other stnu or If grcgulnt on�constn+ccion ohitz work will f th pe:lo mnnc ol'eonstrucrion or nae. Thep nn 6 =-� Phone Number ��% Property Owners Name Fax j Plumbing Cori ^JfJ , - �r 7� `-` ��"'r% / Office,P`ho�n/e mpany �1l` t ` 7! �- ,City �y ,ita�.e, p Co.Address: 2LLL—) �/fir tate!q icatiott/Registra.tion# z � License Holder(Priat}: Nolmrized Signature of License Holder ,.1 20 F.More rnC this ti day of � _ .v.re�aoa,ruve.arr .i gnature of Notary Public til N1Y Cf3b1bf1SS10N a H011 �'i'a ,�` F.k?iAic•ennt'rt �m