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1980 Mipaula Ct 2014 Repipe CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD =J ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 14-00000963 Date 6/16/14 Property Address . . . . . . 1980 MIPAULA CT Application type description PLUMBING ONLY Property Zoning . . . . . . . RES SF DISTRICT Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc repipe 14 ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ ROWLAND, MILLS E & REBECCA D ROLLAND REASH PLUMBING . 1980 MIPAULA CT 11501 W COLUMBIA PARK DR ##208 ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32258 (904) 260-7059 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc . . Permit Fee . . . . 153 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 12/13/14 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . STATE PLBG DCA SURCHARGE 2 . 30 STATE PLBG DBPR SURCHARGE 2 . 30 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 153 . 00 153 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 4 . 60 4 . 60 . 00 . 00 Grand Total 157 . 60 157 . 60 . 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: / CPO , 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: YPE 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 TVacuum Breakers Laundry Tray Water Connected Appliances Lavatory ���� Water Heater Other Fixtures IO 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 application and know the same to be true and correct. Allprovisions of laws and ordinances governing this work will be complied with whether specified or not. The permit does not give authority iolate the pro . ions of any other state or local law regulation construction or the performance of construction. Property Owners Name �lL ��� Phone Number Plumbing Company O O Office Phone Qg2 705 Fax Co. Address city i�l�•[1f State Zip License Holder(Print): S to Ce ication/Registration#G�eDS71' / Notarized Signature of License Holder s�,�;gYI�- Pam E. Quarrels Before me this da7;�e 20 ? :c COMM.ISSION#EE058400 a �e FYI,. _s:FEB.12,2015 Signature of Notary Public rr4yvr.?.AR0NN0TARYc0m