182 Magnolia St PLRS19-0160 Replace 10 Fixtures ' PLUMBING RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH
PLRS19-0160
800 SEMINOLE ROAD ISSUED: 8/26/2019
EXPIRES: 2/22/2020
ATLANTIC BEACH, FL 32233
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORMTO THE CURRENT 6TH EDITION1 OF •
CODE, AND OF • OF • '
ALL CONDITIONS OF • . 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: 01 DESCRIPTION: VALUE OF WORK:
182 MAGNOLIA ST PLUMBING RESIDENTIAL replace 10 fixtures $3000.00
TYPE OF
ZONING: :D •
CONSTRUCTION: NUMBER: GROUP:
170615 0000 SALTAIR SEC 01
COMPANY: DD
MIKE SANVILLE PLUMBING 5627 Verna Blvd. #3 JACKSONVILLE FL 32205
INC
_� ADDRESS: rAt
-
Kirik Patricia 182 Magnolia St 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 •
i Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 10 $70.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$129.00
Issued Date: 8/26/2019 1 of 2
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904)247-5826 Fax (904) 247-5845
JOB ADDRESS: / r
9 S/U r 1 r 1L rERMIT
NEW OR REPLACEMENT INSTALLATION: Project Value$ �}
TYPE of FIXTURE QTY TYPE of FIXTURE QTY
Bathtub Septic Tank&Pit
Clothes Washer f 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
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:
❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
❑ Lawn Sprinkler System-Number of Heads ❑ Well
**SJR WD 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 a�rity to violate the provisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name Phone Number
Plumbing Company r' Q M c �,C- elk-4-1,1 (/1 Office Phone '"07 1/ Fax
Co. Address: !' 2y.Q� KI(I—�11 fl City ,�ax State l�L' Zip 70290
License Holder(Print): C/�Q JG� �� to Certification/Registration MJCO ,7
Notarized Signature of License Holder
.1�Y P,',• I
JOHNSTON Before me this a day of � ikJ 20�_
' ION#GG 042W
ctober 2T,2020
Signature of Notary Public
%'Fob��o?+ ry Pu
c Undefwtiters