168 Magnolia St 2012 plumb CITY OF ATLANTIC BEACH
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J 800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
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Application Number . . . . . 12-00001681 Date 11/13/12
Property Address . . . . . . 168 MAGNOLIA ST
Application type description PLUMBING ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
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Application desc
2 fixtures
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Owner Contractor
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SULLIVAN KATHY G WILLIAM' S BIG BOY PLUMBING INC
2216 OCEANFOREST DR W 516 SOUTH 11TH AVE
ATLANTIC BEACH FL 322334568 JAX BEACH FL 32250
(9 04) 241-1880
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Permit PLUMBING PERMIT
Additional desc . . . 00
Permit Fee . . . . 69 . 00 Plan Check Fee
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 5/12/13
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Other Fees . . . . . . . . . STATE PLBG DCA SURCHARGE 2 . 00
STATE PLBG DBPR SURCHARGE 2 . 00
Fee summary Charged Paid Credited Due
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Permit Fee Total 69 . 00 69 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 73 . 00 73 . 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
h(904) 247-5826 Fax (904) 247-5845
.TOB ADDRESS: r
aio { ( PERMIT# 12 -IleD(/
l
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPE OF F/XTURE QTY TYPE OF FIXTURE QTY
Bathtub Septic Tank& Pit
Clothes Washer Shower
Dishwasher I Shower Pan
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet
Hose Bibs Urinal
Kitchen Sink _t Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
RE-PIPE:
TYPE OF F/XTURE 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)
[-i 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 t�� c 5 ��c- P - Office Phone Fax
Co. Address: S Qt (IV,+V, i C'of City 30-.,c State�L_ Zip 225�S
License Holder(Print): Vc t>� �goa0)OW C' State Certification/Registration# �f 60 o0
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Nota ' der
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14,2014
underwriters
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