164 Magnolia St 2013 repipe CITY OF ATLANTIC BEACH
\ I11
J 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
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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
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Application desc
WWO 9 FIXTURES
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Owner Contractor
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GRIFFITH MELODY R AMERICAN ELECTRICAL CONTRACTOR
164 MAGNOLIA ST 5065 ST. AUGUSTINE RD #13
ATLANTIC BEACH FL 322334006 JACKSONVILLE FL 32207
(904) 737-7770
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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
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Other Fees .
STATE PLBG DCA SURCHARGE 3 . 54
STATE PLBG DBPR SURCHARGE 3 . 54
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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.