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1365 Rose St - Plumbing 8 Fixtures (--- j !-1'ly \ 4`' - r ��s CITY OF ATLANTIC BEACH i; -, . j 800 SEMINOLE ROAD J, — ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5814 ,Olil r)r PLUMBING PERMIT MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247 -5814 JOB INFORMATION: Job ID: 16 -PLBG -302 Job Type: PLUMBING ONLY Description: PLUMBING - 8 FIXTURES Estimated Value: $1,200.00 Issue Date: 2/8/2016 Expiration Date: 8/6/2016 PROPERTY ADDRESS: Address: 1365 ROSE ST RE Number: 171064 -0110 PROPERTY OWNER: Name: SOVEREIGN INVESTMENT GROUP LLC, * Address: 2728 DAVIE BLVD SUITE 134 FEES: State PLMG DBPR Surcharge $2.00 State PLMG DCA Surcharge $2. 00 Plumbing Fixtures $56.00 Trade Permit Base Fee $55.00 Total Payments: $115. 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 1 ( ...17L.66-; _ 3D a JOB ADDRESS: , 6 5 Post: .c I PERMIT # A i ?c(n ice. 22 33 NEW OR REPLACEMENT INSTALLATION: Project Value $ 1 0 c — TYPE OF FIXTURE QTY TYPE OF FIXTURE Bathtub g.... QTY Clothes Washer Septic Tank & Pit Dishwasher Shower Drinking Fountain Shower Pan Floor Drain Slop Sink Floor Sink Three Compartment Sink Hose Bibs Toilet Kitchen Sink Urinal Laundry Tray Vacuum Breakers Lavatory Water Connected Appliances Other Fixtures Water Heater © Water Treating System RE -PIPE: I TYPE OF FIXTURE QTY TYPE OF FIXTURE Bathtub QTY Clothes Washer Septic Tank & Pit Dishwasher Shower Drinking Fountain Shower Pan Slop Sink Floor Drain Floor Sink Three Compartment Sink Hose Bibs Toilet Kitchen Sink Urinal Laundry Tray Vacuum Breakers Lavatory Water Connected Appliances Other Fixtures Water Heater Water Treating System MISCELLANEOUS: ] Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor (Trap) gallons (Requires 3 sets of plans) 1 Lawn Sprinkler System - Number of Heads ❑ Well ** * SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.** 'Other rmit 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 s 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 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. •operty Owners Name Ot IV - . 2 4co z3 g2,i v ,� -- Phone Number 3 3 3 -‘,r!, 0� umbing Company a Li) M Gq N6 1 Y ,, 0S 14 , IA 4: Office Phone- 7 57 0,6 Fax ). Address: 56 5'1 *L O 1LA L : V F.: City SA . State FL Zip 3 cense Holder (Print): r - v a e - ertification/Registration # C-/C° ¥3 O-S 4 tarized Signature of License Hol • _ , •y� TONI GINDLESPEGER I , ,. r� MY COMMISSI I 9$he is - illara A 2 I _ ' ; ,.•:::' day of 4■14F ` .. EXPIRES: October 6, 2019 ';S,Qt 3' E3ondedThro rota 7 ` ; y�° — � � Notary Public �,,, / .,,,,►y