201 Pine St plbg permitCITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
PLUMBING RESIDENTIAL -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO:
PLRS17-0164
Description:
install 10 fixtures
Estimated Value:
0
Issue Date:
12/12/2017
Expiration Date:
6/10/2018
PROPERTY ADDRESS:
Address: 201 PINE ST
RE Number: 170565 0000
PROPERTY OWNER:
Name: BIGGAR RYAN M
Address: 201 PINE ST
ATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: B & G PLUMBING CO., INC.
Address: 2232 CORPORATE SQUARE BLVD 2232 CORPORATE
SQUARE BLVD
JACKSONVILLE, FL 32216
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.
eb
PLUMBING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph (904) 247-5826 Fax (904) 247-5845
1OB ADDRESS: 201 Pl n e -r
' EW OR REPLACEMENT INSTALLATION: Project Value $
f(-VSF� -o1"
PERNMT# 102'_ O
TYPE OF FIXTURE OTY
TYPE OF FIXTURE
Bathtub 1
Septic: Tank & Pit
Clothes Washer —
Show, -r
Dishwasher I
Show -,r Pan
Drinking Fountain —
—
Slop Sink
Three Compartment Sunk
Floor Drain
—
Toilet
Floor Sink
I
Urinal
Hose Bibs
Kitchen Sink 1
Vacuum Breakers
Laundry Tray —
Water Connected Appliances
Lavatory 2
Water Heater
Other Fixtures
Water Treating System
RE -PIPE:
TYPE of FIXTURE OTY
TYPE' OF FIXTURE
Bathtub
Septi; Tank & Pit
Clothes Washer
Shower
Dishwasher
Show er Pan
Drinking Fountain
Slop Sink
Threv Compartment Sink
Floor Drain
Toilet
Floor Sink
Urinal
Hose Bibs
Kitchen Sink
Vacuum Breakers
Laundry Tray
Water Connected Appliances
Lavatory
Water Heater
Other Fixtures
Water Treating System
MISCELLANEOUS:
❑ Sewer Replacement o Back Flow Pmventer
QTY
o Grease Interceptor (Trap) gallons (Requires 3 sets of plans
O 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 sus)renlied or abandoned for six months. I hereby certify that I have rea
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.
Property Owners Name L eS\�� U Y Phone Number (t10 `+) 2 �' ' cr' G
p q
Plumbing Compan �� UI>1 bI N CO _Office Phone 004)22 3 -- 3595 Fax cl0 t -�0,
y
Co. Address: 213 Coy vat t? S ur e B v� City ?d c -tcS u n v 11 Q_ State F!_ Zip 31 2.1 U
License Holder (Print): Certification/Registration # C E=G0225t13
Notarized Signature of License Holder �-'� '
wom and subscribed before i s' y of Q C 0—
•..,, fir,,,., Lon! S. r EN
Notary Public of Elorlaa Signature of Notary Public �l --
• Commtaa X947336 �Yr✓' - � ( 33 � �� �OzO
Iss"•I 11' • My Comm. E Mar tar Mm. /1J e,,,,,• PIilf.�
SOndad Mro, nal Notary ban. 1 I ►1 r_
DESCRIPTION
PermitTRAK
•
•
PAID
$129.00
PLRS17-0164 Address: 201 PINE ST
APN: 170565 0000
$129.00
PLUMBING
$125.00
PLUMBING BASE FEE
455-0000-322-1000
0
$55.00
PLUMBING FIXTURES
455-0000-322-1000
10
$70.00
STATE SURCHARGES
$4.00
STATE DBPR SURCHARGE
455-0000-208-0600
0
$2.00
STATE DCA SURCHARGE
TOTAL FEES PAID BY RECEIPT:11
45500002080700
0
$2.00
Date Paid: Tuesday, December 12, 2017
Paid By: B & G PLUMBING CO., INC.
Cashier: LE
Pay Method: CREDIT CARD 4
00
S
Printed: Tuesday, December 12, 2017 3:54 PM 1 of 1 1
TRAW
Date Paid: Wednesday, December 20, 2017
Paid By: B & G PLUMBING CO., INC.
Cashier: LE
Pay Method: CREDIT CARD 6
Printed: Wednesday, December 20, 2017 4:06 PM 1 of 1
,nwci,