Permit Plbg Repipe 160 Magnolia 2011 ri" S \ CITY OF ATLANTIC BEACH
"' 800 SEMINOLE ROAD
!:1' , ATLANTIC BEACH, FL 32233
`� INSPECTION PHONE LINE 247 -5826
Application Number 11- 00001771 Date 3/08/11
Property Address 160 MAGNOLIA ST
Application type description PLUMBING ONLY
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
15 fixtures
Owner Contractor
EWART, RICHARD WATSON MAINTINENACE SER.CO.
4456 -02 SUNBEAM RD
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32257
(904) 899 -6840
Permit PLUMBING PERMIT
Additional desc .
Permit Fee . . . 160.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 9/04/11
Other Fees STATE PLBG DCA SURCHARGE 2.40
STATE PLBG DBPR SURCHARGE 2.40
Fee summary Charged Paid Credited Due
Permit Fee Total 160.00 160.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.80 4.80 .00 .00
Grand Total 164.80 164.80 .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: /6 2 /4 `1"I 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:
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub 3 Septic Tank & Pit
Clothes Washer /' Shower
Dishwasher / Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet ,2
Hose Bibs o"Z Urinal
Kitchen Sink / Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory , 3 Water Heater /
Other Fixtures tt Water Treating System
v4ISC 7 t A NEOUS: I t
Sewer ??ef lacement ❑ 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
'emit 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
>r 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.
?roperty Owners Name i 0i1a4A / S k , 6: Phone Number 7-r
?lumbing Company LJ -'t' c•V' , /..1 Al13/p,r6- Office Phone 7-.77-4,337 Fax YIY-k, t d.7
o. Address: H4 Z ®L6 Stixi4 City - -c/Lf4 v d` 4 2tate L - Zip 12.2 J7
License Holder (Print): / G am . jc, . 'tat ertificatio Registration #Ci'e DJ
Notarized Signature of License Holder ,, l " , I/L
Sworn and subscribed before me t . " day of
o � . � ��
CATHY ORtc
Signature of Notary Public r� ' � � Y 1� + , , k
I ' 4 0 - ' l • E :August 11, 2014 .._
. R oo Bowed Thor Budget 'Mary services