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164 Magnolia St 2013 repipe CITY OF ATLANTIC BEACH \ I11 J 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Jf3lSA Application Number . . . . . 13-00002763 Date 5/30/13 Property Address . . . . . . 164 MAGNOLIA ST Application type description PLUMBING ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ------------------------------------------- Application desc WWO 9 FIXTURES -------------------------------------------- Owner Contractor ---------------- ------------------------ GRIFFITH MELODY R AMERICAN ELECTRICAL CONTRACTOR 164 MAGNOLIA ST 5065 ST. AUGUSTINE RD #13 ATLANTIC BEACH FL 322334006 JACKSONVILLE FL 32207 (904) 737-7770 ------------------------------------------ Permit . . . . . . W/W/O PLUMBING PERMIT Additional desc . . . 00 Permit Fee . . . . 236 . 00 Plan Check Fee Issue Date . . . . valuation . . . . 0 Expiration Date . . 11/26/13 ---------------------------- Other Fees . STATE PLBG DCA SURCHARGE 3 . 54 STATE PLBG DBPR SURCHARGE 3 . 54 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- -- Permit Fee Total 236 . 00 236 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 7 . 08 7 . 08 . 00 . 00 Grand Total 243 . 08 243 . 08 . 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 PERMIT# 1-3 y TOB ADDRESS: STEW OR REPLACEMENT INSTALLATION: Project Value$ TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY Bathtub Septic Tank&Pit Shower Clothes Washer Dishwasher Shower Pan Drinking Fountain Slop Sink Floor Drain Three Compartment Sink Toilet Floor Sink Urinal Hose Bibs Vacuum Breakers Kitchen Sink Water Connected Appliances Laundry Tray Water Heater Lavatory Water Treating System Other Fixtures RE-PIPE: TYPE OF FIXTURE QTY TYPE OF FIXTURE QT' Septic Tank&Pit Bathtub Shower Clothes Washer 1 i Shower Pan Dishwasher Drinking Fountain Slop Sink Floor Drain Three Compartment Sink Toilet �- Floor Sink Urinal Hose Bibs Vacuum Breakers Kitchen Sink Water Connected Appliances Laundry Tray —�— Water Heater —1-- Lavatory Water Treating System Other Fixtures MISCELLANEOUS: allons(Requires 3 sets of plans) ❑ Sewer Replacement ElBack Flow Preventer ❑ Grease Interceptor (Trap) * g ❑ Well ❑ Lawn Sprinkler System-Number of Heads ** SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.* ❑ Other t I have Permit becomes void if work does not commence within a elmonth of laws and ordinancesor work is suspended or abandoned work six vvml be complied with wheths.I hereby certify aer specified this application and know the same to ri true and correct. provisions 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. Phone Number Property Owners Name -/ 3 Fax � Plumbing Company � er`g � P L ice on N3 i tate - Zip -1 Co. Address: License Bolder (Print): � d /)') He St rtificatioi ration# r�d���� Notarized Satur e of'�iceaz e Ha ea� ��R\ 20 Ki bscribed before m day Notary Public .; ;• My Comm.Exp a Apr 8 2016 otm.y public Com...- Bonded Through National Notary Assn.