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
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Application desc
15 fixtures
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Owner Contractor
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------------------------ ----------
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
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Permit PLUMBING PERMIT
Additional desc Plan Check Fee . 00
Permit Fee . . . . 160 . 00 0
Issue Date Valuation
Expiration Date . . 3/08/15
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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