Permit Plbg 348 2nd St 2012 r Jr
� , CITY OF ATLANTIC BEACH
v 51 800 SEMINOLE ROAD
J ; „u -_ ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
J„ i
Application Number 12- 00000562 Date 5/09/12
Property Address 346 2ND ST
Tenant nbr, name UNIT 348
Application type description PLUMBING ONLY
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
4 fixtures
Owner Contractor
MALONE MARY C TERRY VEREEN PLUMBING
346 2ND ST 2934 POST STREET
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32205
(904) 384 -5661
Permit PLUMBING PERMIT
Additional desc .
Permit Fee . . . 83.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 11/05/12
Other Fees STATE PLBG DCA SURCHARGE 2.00
STATE PLBG DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 83.00 83.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 87.00 87.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
/2, - CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
_ / Ph (904) 247 -5826 Fax (904) 247 -5845
L /
JOB ADDRESS: 3 - - - c kExit PERMIT
YEW 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
[tE -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:
.7 Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor (Trap) gallons
(Requires 3 sets of plans)
3 Lawn Sprinkler System - Number of Heads ❑ Well **
`* SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection. **
Other
'ermit 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
his 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
tr 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.
koperty Owners Name /912.4 G /0' — Phone Number ,1‘, �?5.C6
'lum 4 bing Company y 14,c,,5 A) Muwei 'rice Phone .3k9,5 Fax 38 g -
�o. Address: - City Zip ? (215
S tate�� Zi
.icense Holder (Print): _� = " RE E State Certification /R tttl:8'tgrs OP FI.p12r A o
Notarized Signature of License H, : J L - �' - .
(lean Hi Edward; S 9
,, . Commission #D
Sworn and subscribed before me this day n IC B OD I NG e e, I 2 0��
Signature of Notary Public _ p,,, 2 , g ct