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1767 seminole Rd 2014 plumb CITY OF ATLANTIC BEACH l 800 SEMINOLE ROAD z N� ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 14-00001494 Date 9/10/14 Property Address . . . . . . 1767 SEMINOLE RD Application type description PLUMBING ONLY Property Zoning . . . . . . . RES GEN 2F DISTRICT Application valuation . . . . 0 ----------------------------------- Application desc 11 fixtures --------------------------------- Owner Contractor -------- ----- ------------------------ ---------- - JERPBAK, DONALD M BILL FENWICK PLUMBING 1767 SEMINOLE RD 11623 COLUMBIA PARK DR E ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32258 (904) 242-0444 (904) 724-7022 --------------------------------- Permit PLUMBING PERMIT Additional desc Plan Check Fee . 00 Permit Fee . . . . 132 . 00 0 Issue Date Valuation Expiration Date . . 3/09/15 ----- Other Fees _ STATE PLBG DCA SURCHARGE 2 • STATE PLBG DBPR SURCHARGE 2 . 00 Fee summary Charged Paid Credited Due _ ---------- --------- ---------- ---------- - . 00 Permit Fee Total 132 . 00 132 . 0000 00 . 00 Plan Check Total • 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 Grand Total 136 . 00 136 . 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: 13(01 �1QP � _PERMIT# NEW OR REPLACEMENT INSTALLATION: Project Value$tL41 LA S5-Do 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 21 Urinal Kitchen Sink l 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) ❑ Lawn Sprinkler System-Number of Heads ❑ Well ** ** SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.** ❑ Other eriod or work is suspended or abandoned for six months.I hereby certify that 1 have read Permit becomes void if work does not commence within a six month p 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 er Phone NumbergL -2q2-'D4yq Plumbing Company VIS �e �-� 1 ��nG Office Phone 04--70q"16ZZFax -7 Co. Address: 111223 C�� �� �C�C fir' C City J �)( State —t-1 Zip 3-2-L2152— License 225License Holder(Print),\WC1Fn State Certification/Registration# NotRM e o 'c s der , lCFehefo4r-ee Public CState um of Florida worn and subscr L�_day of 20 T Slomission EE070747 03/06/2015 ignature of Notary Public