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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