201 MAGNOLIA ST PLBG PERMIT 14. CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
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INSPECTION PHONE LINE 247-5814
;
PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
]OBINFORMATION:
Job ID: 16-PLBG-1595
Job Type: PLUMBING ONLY
Description: install new bathtubs (2), washer, dishwasher, sink, lavatories (4),
shower, toilets (3), water heater, hose bibs (2)
Estimated Value:
Issue Date: 7/15/2016
Expiration Date: 1/11/2017
PROPERTY ADDRESS:
Address: 201 MAGNOLIA ST
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: HERZER PLUMBING SERVICE
Address: 3453E RED OAK CIR GLENN EUGENE BUCHMAN
Phone: -
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $112.00
Trade Permit Base Fee $55.00
Total Payments: $171.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233
Ph(904)247-5826 Fax(904)247-5845
JOB ADDRESS: SDI ffl a n of 5 E PERMrr# I (Z Qq tl
NEW OR REPLACEMENT INSTALLATION: Project Value$
TYPEOFFMmAE QTY TYPE OFFmm"
Bathtub QTY
Clothes Washer Z Septic Tank&Pit
Dishwasher +— Shower _
Drinking Fountain —�- Shower Pan
Floor Drain Slop Sink
Floor Sink Three Compartment Sink
Hose Bibs Toilet —4—
Kitchen Sink Urinal
Laundry Tray Vacuum Breakers
Lavatory Water Connected Appliances
Other Fixtures - Water Heater 1_
Water Treating System _
RE-PIPE:
TYPEOFF&TuRE QTY TYPEOFFIXTu8E QTY
Bathtub Septic Tarek&Pit
Clothes Washer Shower —
Drinkin Fountain
Shower Pan —
Floor ng Fountain Slop Sink —
Floor Floor Drain Three Compartment Sink —
HoseBink Toilet F —
Kitc Bibs Urinal —
Laundn Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Water Heater —
Other Fixtures Water Treating System
MSCELLANEOUS:
3 Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor(Trap)_gallons(Requires 3 sets of plans)
7 Lawn Sprinkler System-Number of Heads ❑ Well +,
*SIRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection.**
i Other
avdt 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-
s application and know the same to be true and correct. All previsions of laws and ordinmem goveming this work will be complied with whstber specified
mt. Thepermit does not give authority to violate the provisions of my other site or local law regulation construction or the performance of construction.
operty Owners Name
Phone Number
umbing Company—1:Qrze(5 PI(1mJ3h* Sg!c1zKc 3.nc Office PhonegW-�bg n2 Fax qo9�17a-�ss6
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cense Holder(Print): �ICnn IEl./rvG wtr State Certification/Registration# CY=C03397i
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