1065 Hibiscus 2014 plumb n, CITY OF ATLANTIC BEACH
l 800 SEMINOLE ROAD
j � ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . 14-00001465 Date 9/04/14
Property Address . . . . . . 1065 HIBISCUS ST
Application type description PLUMBING ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
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Application desc
repipe 9 fixtures
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Owner Contractor
-
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SALT AIR HOMES PLUMBING BY JOSH
226 TALLWOOD RD 5677 FLORAL AVE
JACKSONVILLE BEACH FL 32250 JACKSONVILLE FL 32211
(904) 745-3330
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Permit . . . . . . PLUMBING PERMIT
Additional desc .
Permit Fee 118 . 00 Plan Check Fee 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 3/03/15
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Other Fees .
. STATE PLBG DCA SURCHARGE 2 . 00
STATE PLBG DBPR SURCHARGE 2 . 00
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Fee summary Charged Paid Credited ----Due---
----- ---------- ----------
Permit Fee Total 118 . 00 118 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 122 . 00 122 . 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: �DG.S % ,SC(/S C' PERMIT#
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:
YPE of FIXTURE QTY TYPE of FIXTURE QTY
Bathtub Septic Tank&Pit
Clothes Washer —� Shower
Dishwasher 1 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 _03_ Water Heater
Other Fixtures Water Treating System
MISCELLANEOUS:
❑ Sewer Replacement ❑ Back Flow Preventer ❑ rease 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 provisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name Phone Number &33-6607
Plumbing Company elm 61 -os� - Office Phone 937-5706 Fax
Co. Address: -5677 rlDO!�4 f '40e city , Staten zip3a���
License Holder(Print): S State Certification/Registration# SCO yuD-s
Notarized St nature o Licen e l e
.r+�•ty tJofary Public Stato of Florinef a me this day o 20
Shirley L Graham
�a� My Commission FF 086990
"�,,,ad� Expires 0 211 412 0 1 8 Si tune of Notary Public