The URL can be used to link to this page

179 PINE ST BATH AND PLUMB 2016 e 4 " � CITY OF ATLANTIC BEACH A j 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5814 J,fl9'' PLUMBING PERMIT MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247 -5814 JOB INFORMATION: Job ID: 16 -PLBG -880 Job Type: PLUMBING ONLY Description: 2 FIXTURES Estimated Value: $600.00 Issue Date: 4/14/2016 Expiration Date: 10/11/2016 PROPERTY ADDRESS: Address: 179 PINE ST RE Number: 170635 -0075 PROPERTY OWNER: Name: PERRY, SUSAN Address: 179 PINE ST GENERAL CONTRACTOR INFORMATION: Name: CALL PLUMBING INC Address: 5436 KENNERLY RD Phone: - - FEES: Trade Permit Base Fee $55.00 State PLMG DCA Surcharge $2.00 State PLMG DBPR Surcharge $2.00 Plumbing Fixtures $14.00 Total Payments: $73. 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 JOB ADDRESS: 17 q / ,0 c S 72e of PERMIT # om NEW OR REPLACEMENT INSTALLATION: Project Value $ GAO " TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY Bathtub f_ 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 RE -PIPE: TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY Bathtub Septic Tank & Pit Clothes Washer Shower 1 Dishwasher Shower Pan J— 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 ** ** 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 goveming 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. Property Owners Name S 05 PeA/t Phone Number Plumbing Company CA LL PL urn i, j /V Office Phone F!c 0 - rfl S I y Fax Co. Address: g e < / < .. City �Ackcotil ve Lt-r State -L Zip ?7 Z a7 License Holder (Print): CC,'7c t,` 0,)1 State Certification/Registration # CFCD s Sl No • r v - — iw■- S EPHEN HAFT � ° ��: Notary Public - State of Floridg o and subscri . i before me • I + day of A Pte` I 20 /<o t i• j' °`' My Comm. Expires May 5, 2016 ��,. Commission # EE 195483 S nature of Notary Public -° °. .", Bonded Through National Notary Assn. • C s CITY OF ATLANTIC BEACH J 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5814 RESIDENTIAL ALT /OTHER MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247 -5814 JOB INFORMATION: Job ID: 16 -RAAR -881 Job Type: RESIDENTIAL ALTERATION Description: BATH REMODEL Estimated Value: $900.00 Issue Date: 4/14/2016 Expiration Date: 10/11/2016 PROPERTY ADDRESS: Address: 179 PINE ST RE Number: 170635 -0075 PROPERTY OWNER: Name: PERRY, SUSAN Address: 179 PINE ST GENERAL CONTRACTOR INFORMATION: Name: RADON PROFESSIONAL SERVICES Address: 336 14TH AVE QA WILLIAM TONY DAVENPORT Phone: - - PERMIT INFORMATION: FEES: STATE DCA SURCHARGE $2.00 STATE DBPR SURCHARGE $2.00 BUILDING PERMIT FEE $55.00 Total Payments: $59.00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Road, Atlantic Beach, FL 32233 Office (904) 247 -5826 Fax (904) 247 -5845 Job Address: 17i P /Je 5 72e e_ Permit Number: Legal Description /6- /( / 6 — 2 - 5 -- 2 Parcel # 0 Floor Area of Sq.Ft. Sq.Ft Valuation of Work $ b 0 ' Proposed Work heated /cooled / 6 2'2- non - heated /cooled ( Z Class of Work (circle one): New Addition Alteration Repair Move Demolition pool /spa window /door Use of existing /proposed structure(s) (circle one): Commercial Resident'. ► If an existing structure, is a fire sprinkler system installed? (Circle one . ' es No N /A Florida Product Approval # For multiple products use product approval form Describe in detail the type of work to be performed: ge e t;.t c c Sh vw P.t e -,< S cite/2 c,u Nei — •J a c.) An( if C,t / 7 .4( -r c Property Owner Information: Name: S OS ,4-,m► ( &t 2 Address: ,_ City 47?-4-,47;" C ( 3 a4 Stated. Zip 3 2 t ?; Phone E -Mail or Fax # (Optional) Contractor Information: Company Name: R,ctI6 ed.,:! ( � � "r c s Qualifying Agent: (,or 7 0,4-1/ e .v,o tL 7 Address: 31 l Y 7 Ai IU - City '47 genet State / L Zip • 3726 0 Office Phone 2�' - 2170 Job Site/ Contact Number /- / 2.( Fax # State Certification/Registration # C b S - 77 T 3 Architect Name & Phone # Engineer's Name & Phone # Fee Simple Title Holder Name and Address — Bonding Company Name and Address Mortgage Lender Name and Address Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null and void if work is not commenced within six (6) months, or if construction or work is suspended or abandoned for aperiod of six (6) months at any time after work is commenced. I understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Wells, Pools, Furnaces, Boilers, Heaters, Tanks and Air Conditioners, etc. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. 1 hereby ertify that I have read and examined this a plication and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other federal, state, or local law regulating construction or the performance of construction. Signature of Owner _ Signature of Contractor . ��_ , IL Print Name CS ( 'Pet l Print Name W 7 hs:t Li _e..1... Sworn is and subscri•e• b- o e 'ie Sworn to and subs ibex se thi 1 Day of . AIR • • . , .. 41.11* • thi Day of • . , • . 20 Fro : rp �B,•, ,1 `-:': Notary Public - State of Florida . z , • c.:_ Notary Public - State of F orida 1 = + /i • 5 M Comm. Expires Ma 5.2016 _ • • �� . • = My Comm. Expires May 5. 2016 U • P rc %r`:� `y or gy p o ` = Commission # EE 195483 • r. Public =; r� r Commission # EE 195483 ry Public ; r F ,,,,,,,, Bonded Through National Notary Assn. O ., Bonded Through National Notary Assn. • — — — — 14CC4,vei 0 — -