273 Pine St plbg permit CITY OF ATLANTIC BEACH
cl 800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
r INSPECTION PHONE LINE 247-5814
PLUMBING RESIDENTIAL-
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: PLRS17-0084
Description: replace 4 fixtures
Estimated Value: 2400
Issue Date: 8/22/2017
Expiration Date: 2/18/2018
PROPERTY ADDRESS:
Address: 273 PINE ST
RE Number: 170561 0000
PROPERTY OWNER:
Name: FRANK RAYMOND D JR
Address: 273 PINE ST
ATLANTIC BEACH, FL 322334013
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: ATLANTIC COAST PLUMBING CORP.
Address: 3653 REGENT BLVD APT 305 QA NICHOLAS ARLON PARRISH
JACKSONVILLE, FL 32224
Phone:
PERMIT INFORMATION:
Please see attached conditions of approval
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOU 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.
* A notice of Commencement is only required for work exceeding an estimated value of
$2,500. For HVAC work, a Notice of Commencement is only required when HVAC work
exceeds and estimated value of$7,500.
08/18/2017 15:32 FAX 9046459763 atlantic-coast X001
05-06-1671014 ;Fron,: To;96459353 ;90424'5845
PLUNWING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233
Ph(904)247-5826 Fax (904)247-584.5 1'3 I Dp$3l�
JOB ADDRESS: ?.3 //in - /t✓G / k>$xmur#
NEWO REPLACEME INSTALLATION: Project Values 0 . 00
EOFFUMAir QTX TYPE OPFrxrvpx Q7y
Bathtub Septic Tank&Pit
Clothes Dishwasher
Shower
DrinkizehFo '—""" Shower Pan Z
Drinking Fountain Slop Sink
Floor SinkFloor s Three Compartmeat Sink —
Hobo Bibs Toilet �-
Kitchen Sink Urinal
Laundry Tray Vacuum Breakers
Lavoie ^^ Water Connected Appliances T
Other Fixtures Water Heater
--� Water Treating System
tE-PIPE:
TYPA'oPFmrt/Air Qry TYPeror^avAir QTY
BathtubclotiSeptic Tank&Pit
Dishwasher s Washer Shower
Drinking fshwg ` Shower Pa
—"
Fountain Slop Sink '---"-
Floor Drain Throe Com e
Floor Sink
Hose Bibs Toilet Urinal
sit Sink
Kitchen sink —' UrinalVacuum Braskara
L V&toLationdrgrey Water Connected Applisncee "
Other Fixtures Water Hester
Witter Treating System
(ISCELLANEOUS:
Sewer Replacement 11 Back Flow Preventer ❑GmQ50 Interceptor Map)`gallons(&squires 3 mete of pians)
Lawn Sprinkler System-Number of Heads ❑ Well ++
Other
Well
COrrrPletton Form. Completed orm to he submitted to te$ >�tng Department for final inspection.**
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DESCRIPTION ACCOUNTA I1
PermitTRAK $87.00
PLRS17-0084 Address: 273 PINE ST APN: 170561 0000 $87.00
PLUMBING $83.00
PLUMBING BASE FEE 455-0000-322-1000 0 $55.00
PLUMBING FIXTURES 455-0000-322-1000 4 $28.OD
STALE SURCHARGES $4.00
STATE DBPR SURCHARGE 455-0000-208-0600 0 $2.00
STATE DCA SURCHARGE 45500002080]00 0 $2.00
TOTAL FEES 1 BY RECEIPT: R2348 $87.00
CRY OF ATLANTIC BEACH
800 SENBNOLE RD
ATLANTIC BEAC,R 32233
*22/2017 09:14:50
CREDIT CARD
NSA SNE
Cad# KK)xKKWY=5358
SEQ#: 4
BM#: 431
INVOICE 4
Approval Code: 081457
8t y Ndhod. 113121
Able: OIYR
Tax A wIt: $0.00
Card Code: M
SALE AMOUNT P.W
CUSTOWR COPY
Date Paid:Tuesday,August 22, 2017
Paid By:ATLANTIC COAST PLUMBING CORP.
Cashier: BA
Pay Method: CREDIT CARD 4
Printed:Tuesday,August 22,2017 9:15 AM 1 of 1
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