93 Kimberly Ct 2014 Plum CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
j ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Jjilt
Application Number . . . . . 14-00001012 Date 6/24/14
Property Address . . . . . . 93 KIMBERLY CT
Application type description PLUMBING ONLY
Property Zoning . . . . . . . RES GEN MF DISTRICT
Application valuation . . . . 0
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Application desc
12 fixtures
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Owner Contractor
-
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DOMIMICK II, ESMOND LESTER TOUCHTON PLUMBING
1431 RIVERPLACE BLVD #2310 416 RYAN AVENUE
JACKSONVILLE FL 32207 JACKSONVILLE FL 32254
(904) 389-9299
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Permit . . . . . . PLUMBING PERMIT
Additional desc .
Permit Fee 139 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 12/21/14
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Other Fees .
. STATE PLBG DCA SURCHARGE 2 . 09
STATE PLBG DBPR SURCHARGE 2 . 09
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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
. 00
Grand Total 143 . 18 143 . 18 . 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)21447,-58226 Fax (904) 247-5845
JoB ADDRESS: �� I�UA/►'T PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$ 2-00.
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Z 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:
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
**SJRWD 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.l hereby certify that I have read
this application and know the same to be true and correct. All provisions of laws and ordinances governing this work will be complied with whether specified
or not. The permit does not give authority to violate
et
v-io�latethe
,provisions of any other state or local law regulation construction or the performance of construction.
i�
Property Owners Name s� r 1 w l G Phone Number
� ►
Plumbing Company 51.LCI'l Yl R l.LM611 &Y5 Office Phone c3 bbl-9 Z9 9 Fax c38q- C)ZI Z
Co. Address: LJI L? RU10 Alt"d, City J-f�wywL[it2 State k— Zip3Z25
License Holder(Print): r► O�C��or� State Certification/Registration# C'I�G US(ay v">
Notarized Signature of License Holder
SHERRY HAYES
orn and subscribed before me this a�3 r qday of �lUr)C'. 20 1'4
� Y MY COMMISSION Y FF 082292
EXPIRES:March 3,2018 S afore of Notary Public --
y'f Q0.`` Bonded Thru Notary Pudic underwriters