123 Magnolia St PLRS19-0091 14 Fixtures S PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH PLRS19-0091
800 SEMINOLE ROAD ISSUED: 5/10/2019
is EXPIRES: 11/6/2019
ATLANTIC BEACH. FL 32233MUST
LL
Y 4 PM FOR NEXT DAY INSPECTION.
WORK• INSPECTION• • • • • • 1 OF • '
ALL
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
F
E: In addition t7wchras
equirements of this permit,there may be additional restrictions applicable to this property
ay be found inblic records of this county,and there may be additional permits required from other
nmental entitiewater management districts,state agencies,or federal agencies.
*101
123 MAGNOLIA ST PLUMBINGRESIDENTIAL PLUMBING - 14 FIXTURES $2000.00
TYPE OF ZONING: BUILDINGSUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
SALTAIR SEC 03
170627 0100
COMPANY: ADDRESS:
STEEG PLUMBING 1601 MAIN STREET ATLANTIC BEACH FL 32233
COMPANYINC
OWNER: . . •ESS: CITY: STATE: ZIP:
PETWAYTOM 123 MAGNOLIAST ATLANTIC BEACH FL 32233
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT
IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
LIST OF CONDITIONS
Roll off container company must be on City approved list. Container cannot be placed on City right-of-way.
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
PLUMBING BASE FEE 455-0000-322-1000 0 $5500
PLUMBINGFIXTURES 455.0000322-1000 0 $000
PLUMBING FIXTURES 455-0000-3223000 14 $98.00
STATE DBPR SURCHARGE 455-0000308-0700 0 $2.30
STATE OCA SURCHARGE
455-0000-20806M 0 $2.00
TOTAL:$157.30
Issued Date:5/10/2019 1 of
ALLINFORMATION
Plumbing Permit Application HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, Fl-32233 [�
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT N?(-RS`I q OC rI
JOB ADDRESS: I:P Y-/'�6 �I��g.,8/DI/./ PROJECT VALUE$ _ 0D 0
Cl NEW O REPLACEMENT INSTALLATION and/or ORE-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
LaundryTray Water Connected Appliances_
Lavatory Water Heater
Other Fixtures Water Treating System
❑MISCELLANEOUS \
❑Sewer Replacement
❑ Back Flow Preventer
❑ Lawn Sprinkler System(number of sprinkler heads)
❑Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
❑ Weil "51RWD Well completion Form.Completed form to be submitted to the Building Department for final inspection.•"
❑Other
Permit 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 this application and know the same to 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 give authority to violate the provisions
of any other state or local law regulation construction or the performance of construction.
Name:Owner Nam _//Ja�Af �CA✓)A!3 Phone
t Number:
Plumbing Company:
t f /// �'H �� / Office Ph/o�n/ems: ��J�%[ % - 4) �r�F1ax
Co. Address: Ik 49/��1h7/ / City: Y�State:/�Zip: - ;F5
License Holder. �& h'/4 State Certification/Registration
Notarized Signature of License Holder /,.
The forego) ' trument w s acknowledg before met isL0 d fYCL20N��in the State of Florida,
CountySignature of Notary Publ' C
} Ea Personally Known OR [ ] Produced Identification
FF recss T eof Identification:
;;g' EXPIRES Oc�eru,ae01 YP
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