322 Magnolia St PLRS19-0157 Water Heater PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH PLRS19-0157
800 SEMINOLE ROAD
ISSUED: 8/21/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 2/17/2020
MUST CALL INSPECTION • • • 1 PM FOR NEXT DAY ' •
ALL • 'K MUST CONFORM TO THE CURRENT 6TH EDITION1 OF • ' D' BUILDING
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
NOTICE: In addition to the requirements of this permit,there may be additional restrictions applicable to this property
that may be found in the public records of this county, and there may be additional permits required from other
governmental entities such as water management districts,state agencies,or federal agencies.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK-:-
322 MAGNOLIA ST PLUMBING RESIDENTIAL WATER HEATER $1183.00
TYPE OF
ZONING: : • •
• • GROUP:
170445 0510 SALTAIR SEC 02
COMPANY: + •D• '
FLORIDA DELTA 2716 BROADWAY CENTER BLVD BRANDON FL 33510
MECHANICAL, INC.
• + •D• STATE:
CHALOT JENNIFER A 322 MAGNOLIA ST ATLANTIC BEACH FL 32233-4028
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 • .
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
, a
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 0 $0.00
PLUMBING FIXTURES 4SS-0000-322-1000 1 $7.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $66.00
Issued Date: 8/21/2019 1 of 2
ALL
* INFORMATION
Plumbing Perm
ONPlumbingPermit Application HIGHLIGHTEDIN
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#: TRS1-1((��
_6157
JOB ADDRESS: 322 MAGNOLIA ST PROJECT VALUE $1.183.00
WIVEW OR REPLACEMENT INSTALLATION and/or EIRE-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 1
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)
Well **SJRWD 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.
Owner Name:CHALOT JENNIFER Phone Number: (904)563-6117
Plumbing Company: FLORIDA DELTA MECHANICAL Office Phone: (866)219-0980 Fax(866)219-0729
Co. Address: 8402 LAUREL FAIR CIR SUITE 111 City: TAMPA State: FL Zip: 33610
License Holder: DIMITRE BOBEV to C rtifiC on/Registration # CFC1425917
Notarized Signature of License Holder
The foregoin instrument was acknowledged before me this 20 day of J, 20_0, in the State of Florida,
County of 1
,.�,;�"!�!�'•. EMILY H.MEDINA Signature of Notary Public
-,. *. MY COMMISSION#GG 227056
EXPIRES:June 11,2022 personally Known OR [ ] Produced Identif ation
M•....�e '• �.
°F,";. Bonded Thru Notary Public:Underwriters
-- Type of Identification:'
Updated 10/17/18
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Beach
• • : • •
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DESCRIPTION ACCOUNT CITY PAID
PermitTRAK $66.00
PLRS19-0157 Address: 322 MAGNOLIA ST APN: 170445 0510 $66.00
PLUMBING $62.00
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 1 $7.00
STATE SURCHARGES $4.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTALPAID BY RECEIPT: • • •
$66.00
Date Paid: Wednesday, August 21, 2019
Paid By: FLORIDA DELTA MECHANICAL, INC.
Cashier: CT
Pay Method: CREDIT CARD 285596
Printed:Wednesday,August 21,2019 9:49 AM 1 of 1