168 Magnolia St repipe 2012 I
CITY OF ATLANTIC BEACH
}' Z 800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
j = NSPECTION PHONE LINE 247-5814
t =
12-0()0o0787
Date 6/26/12
Application Number 168 GNOLIA ST
Property Address PLUMBING ONLY
Application type description TO BE UPDATED
Property Zoning 0 -----------------------
----_Application_valuation---------------------------
Application desc ------------------------
10 fixtures---------------------- ------------
Contractor _--__--_-
Owner ----
_------ ----------- STEEG PLUMBING
SULLIVAN KATHY G 1601 MAIN STREET FL 32233
2216 OCEANFOREST DR wFL 322334568 ATLANTIC BEACH
ATLANTIC BEACH -_- (904) _249_5191-------------------
--------------------------
_---Permit . --PLUMBING PER IT , 0 0
Additional desc 125 . 00 Plan Check Fee 0
Permit Fee Valuation
Issue Date 12/23/12 -----------------------
Expiration Date - --------------- -------------- 2 . 00
-------------- ST TE PLBG DCA SURCHARGE 2 . 00
Other Fees ST TE PLBG DBPR SURCHARGE---------------
--- ------------- ---------credited Due
--------------------- Charged Paid ----- ----------
Fee summary ---------- ---------- ----- • 00 . 00
----------------- 125 . 00 125 . 00 . 00 . 00
Permit Fee Total 00 . 00 . 00
Plan Check Total 4 . 00 4 , 00 ' 00 . 00
Other Fee Total 129 . 00 129 . 00 • 00
Grand Total
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALI, CIT OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
's
PLITMBIN O PL�2.MIT PLICATION
CITY OF AATLAN e BEA H
800 Seminole Rd Atlantic Beach,FL 32233
Ph(904) 247-5826 Fax( 4) 247-5845
// HERMIT#
JOB ADDRESS: C� � ���/�'
INTW OR REPLACEMiEIVT INSTALLATION: Project Valve
TYPE of Fi aVRE OTY YPE of FIXTURE OTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher ShowerPan
Drinking Fountain Slop
Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Ijater Connected Appliances
Lavatory ater Heater
Other Fixtures ater Treating System
RE-PIPE:
TYPE oEFtxTuRE QTY TYPE oEFIXTURE fly
Bathtub eptic Tank&Pit
Clothes Washer hower
Dishwasher hower Pan
Drinking untain
to Sink
Floor Drain lop
Compartment Sink
Floor Sink oilet
Hose Bibs --L irinal
Kitchen Sink C Vacuum Breakers
Laundry Tray Weer Connected Appliances
Lavatory 'Water Heater
Other Fixtures 'Water Treating System
MISCELLANEOUS:
❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease In rceptor(Trap) gallons(Requires 3 sets of plat
❑ Lawn Sprinkler System-Number of Heads t Well
X* SJR WD Well Completion.Form. Completed form to be subin tted to the Building Department for fiaal 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 i
this application and know the same to be true and correct All provisions of lawsand ordinances governing this work will be complied with whether specif
or not. The permit does not give authority to violate the provisions of any other state or Iocal law regulation construction or the performance of construct ,
Property Owners Name IA v/� Phone Number
Plu�nbiltg Company - 1r �d �"� Office Phone � i `VD Fax
Co. Address. d
City�, �G /$c h State-Zi z- ,
License]bolder(Print): / �'c' State Certification/Registration
Notarizcd S'i ature of License Holder
SHIRLEY L.GRAHAM ra
a"Id SIIbSCIi befQr �8 S y f200AV COMMISSION#OD 957760EXPIRES:February 14,2014
Bonded 71rcu Notary Public Underwritetire of Nota y bis