181 MAGNOLIA ST - PLUMBING ry-\J\
''- �,'s, CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
s)
\ }----t) ATLANTIC BEACH, FL 32233
\ INSPECTION PHONE LINE 247-5814
PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-PLBG-2445
Job Type: PLUMBING ONLY
Description: 2 FIXTURES
Estimated Value:
Issue Date: 10/15/2015
Expiration Date: 4/12/2016
PROPERTY ADDRESS:
Address: 181 MAGNOLIA ST
RE Number: 170623-0000
PROPERTY OWNER:
Name: SMITH JR, JOHN V
Address: 181 MAGNOLIA ST
GENERAL CONTRACTOR INFORMATION:
Name: ST JOHNS PLUMBING
Address: 2260 S MARLEE RD QA ROBERT GEORGE WILSON
Phone: - -
FEES:
Trade Permit Base Fee $55.00
Plumbing Fixtures $14.00
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Total Payments: $73.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND TIIE FLORIDA
BUILDING CODES.
Oct 151512:44p Mack Brothers 9042200520 p.2
Oct 1515 01:34p st johns plumbing 904-287-4605 p.1
Oct 1515 09.36a Mack Brothers 9042200520 p.1
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd.Atlantic Beach; FL 32233
Ph(904)247-5826 Fax(904) 247-5845
JOB ADDRESS: 181 Magnolia St., Atlantic Beach, FL 32233 PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value$ 350.00
TYPE OF FIXTURE Qn' 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$ibs _ Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray ______ Water Connected Appliances
Lavatory Water Heater
Other Fixtures Water Treating System
RE-PIPE:
TYPE OF FIXTURE Orr TYPE OF FIXTURE Qry
Bathtub Septic"Tank 8r 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 _.
MLSCELLANEOUS:
O Sewer Replacement u Back Flow Preventer ❑Grose interceptor(Trap) gallons(Requires 3 sets of plans)
0 Lawn Sprinkler System-Number of Heads O Well *u
x*SrR WD Well Completion Form. Completed form to be submitted to the Building Department for Taal inspection.**
9 Otter
Permit be;,or:tesvoid ifwOrk does not commence within a Si):month period or work is suspended vt abandoned for six months.I hereby ccctity that I have read
this application and know the same to be true and correct All provisions oflaws and ordinances governing this work will be compliai with whether specified
or not. The permit does not give authoriy to violate the provisions of any other sate or local law regulation construction or the Worm of construction.
Property Owners Name John Smith Phone Number 591-1 612 _
Plumbing Company St. Johns Plumbing _ __ Office Phone 287-2041 Fax 287-4505
Co.Address: 2260 Marlee Rd S City Jacksonville State FL Zip 32259
License Holder(Print): Robert G. Wllsori .n State Certification/Registration#_CFC058030
11! Ir�,�ienature o�.License Holder f t"1tir j
. •-0, PP4MBA nil VIVEMCZ $wom and subscribe d before me L�::s i{' \ day of 0 G L e�. 20 15
iw comussm•FF o961tti
'� sxPtaes-March 4,tote
f aj eel'e"Twta+xri"Icu»n."6tn Signature of Notary Public A