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366 Royal Palms dr Plumb 2014 CITY OF ATLANTIC BEACH j 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 14-00001479 Date 9/09/14 Property Address . . . . . . 366 ROYAL PALMS DR Application type description PLUMBING ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc 3 FIXTURES ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ SALFER, ALLEN R. & ROSE ANN JOHN WILLIAMS PLUMBING, INC. LIFE ESTATE 109 SOUTH COLLEGE STREET 366 ROYAL PALMS DR MACCLENNY FL 32063 ATLANTIC BEACH FL 32233 (904) 259-4580 ---------------------------------------------------------------------------- Permit . . . . . . PLUMBING PERMIT Additional desc . . Permit Fee . . . . 76 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 3/08/15 ---------------------------------------------------------------------------- Other Fees . . . . . . . . . STATE PLBG DCA SURCHARGE 2 . 00 STATE PLBG DBPR SURCHARGE 2 . 00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 76 . 00 76 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 80 . 00 80 . 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:. t�u�( Pct,mS ��1 V� PERMIT# NEW OR REPLACEMENT INSTALLATION: Project Value $ —tLAI:50 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 Diishiwher Shower Pan Drigg 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 ** ** SIR WD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.** ❑ Other Pennitle4us 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 appli ' ion 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 AQOyN -r1�" 11 11\\ Q y qoL1 O Plulpbing Company�'S>J�n W����a,�S P t u n� Office Phone - Fax Co. Address: \U� S ,����. City State'FL Zip O(D License Holder(Print): /State Certification/Registration# CVC Q5(dC1(o i Notarized Signature of License Holder IN 11111''Itio'' E%t.j Notary Public State of FloridaSworn and subscribed before m this_ ij 1 day of p K%�r 20�Sandy Hines My Commission EE 155300 Signature of Notary Public Expires 12/26/2015