372 4TH ST 2014 BATH REMODEL CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
Application Number . . . . . 14-00001283 Date 8/11/14
Property Address . . . . . . 372 4TH ST
Application type description PLUMBING ONLY
Property Zoning . . . . . . . RES SF DISTRICT
Application valuation . . . . 0 ----------------------
-----------------------------------------------------
Application desc
INSTALL 4 FIXTURES
---------------------------------------------
Owner Contractor
------------------------
TDG PLUMBING
HALPERIN, ALAN K 4426 LOYS DRIVE
372 4TH ST JACKSONVILLE FL 32246
ATLANTIC BEACH FL 32233 (904) 545-7341
-- -------------------------------------------------------------------------
Permit . . . . . . PLUMBING PERMIT
Additional desc - - 83 . 00 Plan Check Fee . 00
Permit Fee . . . . Valuation . . . . 0
Issue Date . . . .
Expiration Date 2/07/15 -------------------------------
------------------------------------STATE PLBG DCA SURCHARGE 2 . 00
Other Fees . . . . . . . . . STATE PLBG DBPR SURCHARGE 2 . 00
-- -------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 83 . 00 83 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 87 . 00 87 . 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
Ph(904) 247-5826 Fax (904) 247-5845
JOB ADDRESS: -2 Z-1 7" 3-T- 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
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
MISCELLANEOUS:
[:i Sewer Replacement [:i Back Flow Preventer [:j Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
Ei Lawn Sprinkler System-Number of Heads El Well
** SJRWD Well Completion Form. Complete&-form to be submitted to the-Building Department for final inspection."
El 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 HALP 110-N ('_�Uie\ H__Z' Phone Number
Plumbing Compai�y er -Office Phone S_'y r- ?3%Fax!!�C YA�- [
State r-L zip'�s 124 to
Co. Address: L014-N OIL city
State Certification/Registration# Q�FgZr
License Holder(Print)- _a^VZ!'
Notarized Signature of License Holder
JEWFER WALKER -1lay of
20
Before me this
_J
MY COMMISSION#FF 011480
EXPIRES:Apfil 24.2017
Bonded Thru Notimy Public Underwriers
Signature of Notary Publi