640 Ocean Blvd plumb 1 fixture 2014 S11
CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
!) ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 14-00000859 Date 5/28/14
Property Address . . . . . . 640 OCEAN BLVD
Application type description PLUMBING ONLY
Property Zoning . . . . . . . RES SF DISTRICT
Application valuation . . . . 0
----------------------------------------------------------------------------
Application desc
1 fixture
----------------------------------------------------------------------------
Owner Contractor
-
------------------------
-----------------------
GARCIA III, GEORGE J DAVID GRAY PLUMBING INC.
MARGARET C 6491 POWERS AVENUE
640 OCEAN BLVD JACKSONVILLE FL 32217
ATLANTIC BEACH FL 32233 (904) 724-7211
---------------------------------------------------------------------------
Permit . . . . . . PLUMBING PERMIT
Additional desc . .
Permit Fee . . . 62 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 11/24/14
-------------------------------------------------------------------
Other Fees . . . . . . . . STATE PLBG DCA SURCHARGE 2 . 00
STATE PLBG DBPR SURCHARGE 2 . 00
----------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- -------
Permit Fee Total 62 . 00 62 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 66 . 00 66 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
lnforma-bon S)-.temsC�Ty 0 904247-5845 P.1
Mar 08 10 1_:54p
PLUMING PF10UT APPLICATION
CITE' OF ATLANTIC BFACH
goo Seminole Rd Atlantic Beach,FL 32233
Ph(904)247-5826 Fax(904)247-584-5
�T
OBADRRs SS: (p'1� ��yl ()j• P � #
NEW OR REPLACE1 -N IN S'i',t-LLA'I'10N Project Value $
TYPE oma-Fix-URE OTY TYPE of F-Of TURE OTY
Bathtub Septic Tank&Pit
Shower
Clothes Washer
Dishwasher ShoNmrwer man
Driald;agFolin Slop Co
3 Three Comp;�eat Sin.'c
Floor Drai •
let
Floor Sink. Trina
Hose-BFos urinal
Kitchen Simi Vacuum Breat�rs
Laundry inkraY water Connected Applianc s
Water Heater
;her"�� Water Treating System
R..'L'J-L E.E P .
'pE o-F'LUVR QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan
Drinkins'Fountain Slop Sink
Thrtw Compaatment Sink
Floor Drain
Toiled
Floor Sink
U=31Hose Bibs
Kitchen SinkVacua BreakEr
Laundry Tray Fater Connected Appliances
LavatD water Heater
�' Fater Treating System
Other Fracas
MISCELLANEOUS: ons i (Requiz-- 3 sets of per))
❑ Sewer Replacement ❑ Bank Flow Preventer ❑ Crease Interceptor(Trap) (�
❑ Law- zi Spler-System-lumber of Beads ❑ �Te1 �r
S1Rv7D Wei!Cantpletmon For . Coraplet,rd fo=a to be, subsitted to the Building Depa-tnerat ff�= tel inspe:tion.={
❑ Other.
?�trrir becomes void u work does not c mmence-within a six month period or work is suspended or abandoned for sig months.I hereby certify that I have rid
thus appUcarion and know the sane to be true acid correct. Al provisions of lases and ardinaacrs govc�cing this c°rt will r complied with whether specified
of noL The permit does not Brie authority to vioasft the provisitms of any other state or local law ren nailon con-`>zv� °L d1°P' ° °D of czon/s�trugcaon.
'Let Phone N1�I17bef �Q� J V `
Fr-Ter±y Owners Name V
S`i J 8 YEN e��t.'mbing, Inc. O;fce Phone Far.
Plumbing Company ggQ�Css��
Oi.7JV >~4�i E1%1.F; «+ u. re t,Otll$ State' zip
Co. Address: ,y. r City _
License Holder 'r t). *r �. •� ;�-C SttrtP Certi3n# C rz
cationlRe;istratO
PYotrarued,S�grature of License Hoid-er /� I�iii/y /�L-� (
Sworn and subbed before this�4 day of 20
Sure of Notary Public f,,F•f CA
(,,v►c4 Notary Public State of Florida LaSheica Wilson My Commission EE050523rpo Expires 01/04/2015