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1872 Hickory Ln 2014 plumb CITY OF ATLANTIC BEACH ss> 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 14-00001165 Date 7/22/14 Property Address . . . . . . 1872 HICKORY LN Application type description PLUMBING ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------- Application desc WATER HEATER ------------------------------------------------------ Owner Contractor - ------------------------ ----------------------- PIERSON DAVID GRAY PLUMBING INC. 1872 HICKORY LANE 6491 POWERS AVENUE JACKSONVILLE BEACH FL 32250 JACKSONVILLE FL 32217 (904) 724-7211 ---------------------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc . Permit Fee 62 . 00 Plan Check Fee 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 1/18/15 ---------------------------- 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. Mar 08 10 12:54p Information SystemsClTY 0 90¢247-5845 p.1 CITY OF ATLANTIC BEACH S 00 Seminole Ptd Atlantic Bea:ls,TL 32233 Ph(904)247-526 Fax(904)247-5845 JOB ADDRESS: C10104 33 PFS 9 NEW OR REPLAv HINT INSTA-T-LATION: Project Value s Bathtub Septic Tank&Pit Clothes Washer Shower -3ishw cher -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 �— -Qttier� �. RE-PIPE; , y� v� es water Treafing System TYPE of F 1�T� TYPE'OF F=rURE OT'Y Bathtub Septic Tank&Pit Clothes washer Shower Dishwasher Shower Pan Drinkme Fonntai�p — SLop Sink Floor Di ain Three Compartment Sink Floor Sink Toil Hose Bibs Urinal. Kitchen Sink Vacu!umBrrakEr Laundry Tray water Cannected Appliances H Wat Lavatory eiHeater Other Futures Fater Treating System T�nSCELLA EOUS: ❑ Sewer Fufplacernen_ ❑ Bask Flow Preventer ❑ C-rease Interceptor(Trap) gallons(Requia-- 3 sets of paw) ❑ Law- Spi5' er System--1`=ber ofBeads ❑ Well �T STRl�'D Tel!Gompleion Form. Completed fb=to be submitted to the Luildiug Departneat for EMsl inspes'tion.Y# )0 Other. . - - v. ?rrm*i becomes raid if wor';does not commence within a six month period or works is saspendcd or abandoned for six months.I hereby cenify that I have read this application and know th:-same to be t-ue and correct. Al provisions of Jays and ordinmces govc�tmg this goes vri77 be complied withwhethor spenifie3 rmance or not- The p=mii does not give aut�barity�to viOWc the provisions ooffan�y athcr state or local law zegulation ennstniction or the pc rfatoo of construcson. Pruperty Owners Name .( 1 I��i�J!' 1 Phone Nmnber 0 1/ Plumbing inrnpang QQHS°�ff F?'�� st:i�i58�44�, Inc.. OM-1ce Phone 1 Far. L385U L-,3 prl-m;�� S;Ouiairy 5.;ou g L St�Ctp �� Co. Address: _ _ city IP �License Fr©lret(Frsat): St3tP Certi catianfRegistror � Zi rcSe-d,SigratzaPe of License Holder S-,-mm and subscril;-d before rnee this GL—- day of 20 Sigua=re ofNotary Public gfA,"' (-C_ ° 6 NotaryAI public State of Florida LaSheiea Wilson or wok` My Commission EE050523 Expires 01/04/2015