369 7th St 2014 sewer �s CITY OF ATLANTIC BEACH
is1
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 14-00001208 Date 7/29/14
Property Address . . . . . . 369 7TH ST
Application type description PLUMBING ONLY
Property Zoning . . . . . . . RES SF DISTRICT
Application valuation . . . . 0
-------------------------------------------------------------
Application desc
SEWER REPLACEMENT
--------------------------------------------------------------
Owner Contractor
-
------------------------
-----------------------
PALMER, DOROTHY SKINNER ADVANTAGE PLUMBING
10351 TOLER BRIDGE RD 880 MAYPORT RD
LEWISPORT KY 42351 P.O. BOX 49225
JACKSONVILLE BEACH FL 32240
(904) 247-9848
--------------------------------------------------------
Permit . . . . . . PLUMBING PERMIT
Additional desc . . SEWER REPLACEMENT
Permit Fee 62 . 00 Plan Check Fee 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 1/25/15
-----------------------------------------------------
Other Fees . . . . . . . . . STATE PLBG DCA SURCHARGE 2 . 00
STATE PLBG DBPR SURCHARGE 2 . 00
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ----------
Permit Fee Total 62 . 00 62 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 66 . 00 66 . 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: � �} -7y S) PERmrr#
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:
Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
X **
❑ 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 Phone Number
Plumbing Company Office Phone�Vr18`6 Fax
�
City
Co. Address: / State Z__1__Zip Z23
License Holder(Print): E S1 to Certification/Registration#
Notarized Signature of License Holder 1� '�'�–,�
Sworn and subscribe efore a this day o l.� 20'—i
JENNIFER WALKER
MY CpMM1SSIQN M FF 0114883
Signature of Notary Public
€y � EXPIRES:Apn124 2011
i ud o? Bonded Thru Notary Pudic Unftftriters