1026 BIG PINE KEY - PLUMBING CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
-6 ) ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
- oiti9
PLUMBING PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-PLBG-2048
Job Type: PLUMBING ONLY
Description: 7 FIXTURES
Estimated Value:
Issue Date: 8/28/2015
Expiration Date: 2/24/2016
PROPERTY ADDRESS:
Address: 1026 BIG PINE KEY
RE Number: 172027-5060
PROPERTY OWNER:
Name: BARON, PIERRE A
Address: 1026 BIG PINE KEY
GENERAL CONTRACTOR INFORMATION:
Name: SHAYCORE ENTERPRISES INC
Address: 11235 N ST JOHNS INDUSTRIAL PKWY N CT STE 4 10
Phone: 904-551-2592
FEES:
State PLMG DBPR Surcharge $2.00
State PLMG DCA Surcharge $2.00
Plumbing Fixtures $49.00
Trade Permit Base Fee $55.00
Total Payments: $108.00
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 i 5 — ,P L 6 G—E04 8
JOB ADDRESS: 1Q2(o ."6:V ?t a �.�..f_ PERMIT#
NEW OR REPLACEMENT INSTALLATION: Project Value $ I I1 S
TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY
Bathtub _ Septic Tank& Pit
Clothes Washer Shower
Dishwasher Shower Pan I
Drinking Fountain Slop Sink
Floor Drain Three Compartment Sink
Floor Sink Toilet 3
Hose Bibs Urinal
Kitchen Sink Vacuum Breakers
Laundry Tray Water Connected Appliances
Lavatory Z. 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 o Back Flow Preventer ❑ Grease Interceptor(Trap) gallons(Requires 3 sets of plans)
iii Lawn Sprinkler System-Number of Heads D 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 Step of any other state or local law regulation construction or the performance of construction.
Property Owners Name c�.Ted CrS�p 11 Phone Number
Plumbing Company 56icsre 6jtm 'e((Se.S) i\( Office Phone 551 -25-cj 2- Fax Z3q—30Z77
Co. Address: 1k 235 SA. 54,ns ktai (ta( `'wv t k) City 4.C.- spvts,(tke.. State n Zip 37.2y b
License Holder (Print): bontt.kd_ Q4(ke.J / State Certification/Registration#(:FL v 12 7 3Z Notarized Signature of License Holder OI .
BENJAMIN RIENDEAU Sworn and subscribed before me this Zip day of dio 1 t'- 2015
L - MY COMMISSION 0E072929
v
EXPIRES February 26,2016 Signature of Notary Public
ses.o,ss Romemoterisirtmcom .,