433 Sargo rd 2014 repipe CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
j � ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 14-00001134 Date 7/17/14
Property Address . . . . . . 433 SARGO RD
Application type description PLUMBING ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
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Application desc
REPIPE 10 FIXTURES
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Owner Contractor
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WOODWARD, DOLPHUS J LARRY TEAGUE & SONS PLUMBING
433 SARGO ROAD 203 OCEANFRONT
ATLANTIC BEACH FL 32233 NEPTUNE BEACH FL 32266
(904) 270-2289
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Permit . . . . . . PLUMBING PERMIT
Additional desc .
Permit Fee 125 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 1/13/15
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Other Fees . . . . . . . . . STATE PLBG DCA SURCHARGE 2 . 00
STATE PLBG DBPR SURCHARGE 2 . 00
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- --
Permit Fee Total 125 . 00 125 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand .Total 129 . 00 129 . 00 . 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
22 Ph(904) 247-5826 Fax(904)247-5845
.TOB ADDRESS: ) S O`Z C 70 A 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:
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 oL
Hose Bibs Urinal
Kitchen Sink �_ Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater —l—
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
** 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. 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 the provisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name�� 1 ) too d �Q el Phone Number c�W 91 'O 6,23 1
Plumbing Company LARR.R-Y r atd i%d-Sor�S &U Mint ti!(.-I Office Phone -4 7 0 ,299 Fax J.q 9' 96 cl
Co. Address: 4._�- QN N ERS_ City ee Q State-JJ Zip 3 ZZ4w
License Holder(Print): UO L:� State Certification/Registration# C— CQ01 sag
Notarized Signature of License Holder
MELANIE A.DARLINGTON Sworn and subscribed befo e me this � day of Ul' 204
.� •�: MY COMMISSION*EE198M �.
EXPIRES May 1S.2016 Signature of Notary Publi
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