309 Magnolia St plbg permit CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATI[ON:
Job ID: 16-PLBG-2218
Job Type: PLUMBING ONLY
Description: install new lavatory, shower pan, toilet
Estimated Value: $1,000.00
Issue Date: 9/30/2016
Expiration Date: 3/29/2017
PROPERTY ADDRESS:
Address: 309 MAGNOLIA ST
RE Number: 170450-0000
PROPERTY OWNER:
Name: Acieff, Samule
Address: 309 Magnolia ST
GENERAL CONTRACTOR INFORMATION:
Name; PIPE-RIGHT PLUMBING SVC INC
Carl David Hamm,RF11067SS4
Address: 1311 TROTTERS WALK WAY
Phone:
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $21.00
Trade Permit Base Fee $55.00
Total Payments: $80.00
PERMIT IS APPROVED ONLY W ACCORDANCE WITH ALL CUFF OF ATLANTIC BEACH ORDWANCES AND THE FLORIDA
BUILDING CODES.
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,Fl, 32233
Ph(904)247-5826 Fact(904)247-5845
JoBADDREss: PERMIT#
NEW OR REPLACEMENT INSTALLATION: ProjectValue$
7)rpEoFFixTuRE QTF TYPE oFFirxTuRE QTY
Bathtub Septic Tank&Pit
Clothes Washer Shower
Dishwasher Shower Pan I
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
RE-PIPE:
TYPE oF FixTURE 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:
Ei Sewer Replacement 11 Back Flow Preventer [3 Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
o Lawn Sprinkler System-Number of Heads 0 Well
**SJRWD Well Completion Form. CompiletJ_fonn to be submitted to the Building Department for final inspection."
Li Other
Pennit becomes void if work does not commerce within a six month period or work is auspendedit or abandoned for six months.I hereby cedify thin I have read
this application and know the same in 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 gi,c awhority to violate the previsions of my other state or local law regulation construction or the performance of construction.
Property Ovimers Nam rh 1,/0 Phone Number
Plumbing Company -W-'a a Office Phone!?
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License Holder(Pr A, gof State Certification/Registration# `4118� 7-rrY
Notarized Signature!n0f"Lironve Flaildel W� -
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