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Permit Plbg Shower pan 2215 Alicia 2011 (2) :. rF, CITY OF ATLANTIC BEACH ir. , s) 800 SEMINOLE ROAD J��. �" ATLANTIC BEACH, FL 32233 .,4%, INSPECTION PHONE LINE 247 -5814 Application Number 11- 00002629 Date 9/16/11 Property Address 2215 ALICIA LN / /11 Application type description PLUMBING ONLY Property Zoning TO BE UPDATED Application valuation . . . 0 Application desc 1 shower pan Owner Contractor LEWIS DENISE KLETT LIVING TRST TROY TRAWICK PLUMBING CO, INC 335 W 107TH STREET 6228 LOTTIE ST CARMEL IN 460329587 JACKSONVILLE FL 32216 (904) 721 -8400 Permit PLUMBING PERMIT Additional desc . Permit Fee . . . 62.00 Plan Check Fee .00 Issue Date Valuation . . . . 0 Expiration Date . . 3/14/12 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: 2 Z I 5 .4 1r t`c L h e _ PERMIT # // - r�va 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 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 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 provisions of any other state or local law regulation construction or the performance of construction. Property Owners Name Phone Number Plumbing Company fRogRitutt K / /c4-76/ ;-:6_ (G, Office Phone 72/ Fax 72 / Co. Address: .2 970 err leZi'JJ4, ?C F( 22 City ,- eli K State FL Zip 3 2 2 qlo License Holder (Print): 1: "/—i c " ' State Ce 'fication/Registration # CfC /Y26097 Notarized Signature of License Holder r.'"---------------' p'- --- � lP da o ��L., r 20/1 "�, bscribed before ' SHIRLEYL. MY COMMISSION it DD 957760 EXPIRES: FebrU dire +f Notary Public onded T hru No tary Public nderwniters .4 e ' , • ai