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2277 Seminole Rd # C Plumb CITY OF ATLANTIC BEACH y 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 �r lilt Application Number . . . . . 14-00001480 Date 9/09/14 Property Address . . . . . . 2277 SEMINOLE RD UNIT C Application type description PLUMBING ONLY Property Zoning . . . . . . . RES GEN MF DISTRICT Application valuation . . . . 0 --------------------------------- Application desc 15 fixtures --------------------------------- Owner Contractor -------------- ------------------------ ---------- PEPPER LIFE ESTATE, BARBARA WAYNE CONN PLUMBING INC. 2277 SEMINOLE RD APT C 5627-#7 VERNA BLVD ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32205(904) 353-3102 ------------------------------- Permit PLUMBING PERMIT Additional desc Plan Check Fee . 00 Permit Fee . . . . 160 . 00 0 Issue Date Valuation Expiration Date . . 3/08/15 ----- Other Fees _ STATE PLBG DCA SURCHARGE 2 • STATE PLBG DBPR SURCHARGE 2 .40 _ ________ ---- Fee summary Charged Paid Credited _ _ --------- ----- ---------- ---------- - . 00 Permit Fee Total 160 . 00 160 . 0000 00 . 00 Plan Check Total • 00 . 00 Other Fee Total 4 . 80 4 . 80 . 00 Grand Total 164 . 80 164 . 80 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. i PLUMBING PERMIT APPLICATION CITY OF ATLANTIC BEACH k 800 Seminole Rd Atlantic Beach, FL 32233 Ph(904)247-5826 Fax(904)247-5845 `� PERMIT# JOE ADDRESS: l/� /l 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: S TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY Bathtub Septic Tank&Pit Clothes Washer / Shower Dishwasher i _ Shower Pan Drinking Fountain Slop Sink Floor Drain Three Compartment Sink Floor Sink Toilet Hose Bibs 9. Urinal Kitchen Sink / Vacuum Breakers Laundry Tray Water Connected Appliances T_ 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 ** ** 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. �1 �' " Phone Number�U a, Y�e'9_ Property Owners Name /f1'%'I Plumbing Company k- 'o �O.tJ� �%^ S Office Phone,35,m. /aZ _Fax ,2.�i�'e Co. Address: iL -� !/ -AAJ, City �� State Zip License Holder(Print): State Certification/Registration# Notarized Signature of License Holder :: ti JENNIFER WALKER Before me this_� day of 20 G MY COMMISSION#FF 01?480 �•. :� EXPIRES: '124,2ot7 Signature of Notary Public R hcF•' Banded Thru Wary Public Underwriters