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770 Amberjack Ln 2014 Plumb �} CITY OF ATLANTIC BEACH ss� J 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 �r !tit Application Number . . 14-00001493 Date 9/10/14 Property Address . . . . . . 770 AMBERJACK LN Application type description PLUMBING ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ------------------------------------------------------ Application desc shower pan ---------------------------------------------------- Owner Contractor - ------------------------ ----------------------- SELF, LEWIE F. LARRY TEAGUE & SONS PLUMBING 770 AMBERJACK LANE 203 OCEANFRONT ATLANTIC BEACH FL 32233 NEPTUNE BEACH FL 32266 (904) 270-2289 ------------------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc . Permit Fee . . . . 62 . 00 Plan Check Fee 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 3/09/15 ------------------------------ 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: VAm Jxr ' &4c PERmTT# 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 QT' 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) ❑ Lawn Sprinkler System-Number of Heads ❑ Well ** ** SJRWD 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 pr vision of any other state or local law regulation construction or the performance of:onstruct.1 ro ert Owners Name /'S• �Gr Phone Number �iJJPP_ 1 P p y Office Phone d' O Fax Plumbing Company ,!� 20 O� Cit}, 'V State �Zip�� Co. Address: License Holder(Print): e C ification/Registration Notarized Signature of License Holder MELANIE A.DARLINGTON Sworn and subscribed before me this day of 20-LT MY COMMW*N E EE198739 EXPIRES May 18,2018 Signature of Notary Public \