1816 Atlantic Beach Dr GSRS24-0100 Application Mechanical Permit Application **ALL INFORMATION I
S ��� pp HIGHLIGHTED IN
r \`'' City of Atlantic Beach Building Department GRAY IS REQUIRED.
Y 800 Seminole Road, Atlantic Beach, FL 32233
-;. ."' Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: C�S EL0,\ ()
JOB ADDRESS: IH(" r v G, ' c 3rC- I'\ () 6Z PROJECT VALUE $ SL-1--)
NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI#(REQUIRED)
❑ Air Handling Equipment Only ❑ Condenser Only [1 Air Handling Unit & Condenser
Air Conditioning: Unit Quantity Tons per Unit
Heat: Unit Quantity BTUs per Unit Seer Rating (REQUIRED)
Duct Systems: Total CFM
REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI#(REQUIRED)
❑ Air Handling Equipment Only Li Condenser Only ❑ Air Handling Unit& Condenser
Air Conditioning: Unit Quantity Tons per Unit
Heat: Unit Quantity BTU's Per Unit Seer Rating (REQUIRED)
Duct Systems: Total CFM
FIRE PREVENTION
Fire Sprinkler System Quantity (Requires 1 set of digital plans)
Fire Standpipe Quantity (Requires 1 set of digital plans)
Underground Fire Main Value (Requires 1 set of digital plans)
Fire Hose Cabinets Quantity (Requires 1 set of digital plans)
Commercial Hoods Quantity (Requires 1 set of digital plans)
Fire Suppression Systems Quantity (Requires 1 set of digital plans)
FIRE PLACES n MISCELLANEOUS:
Prefabricated Fireplace (Qty) Automobile Lifts
Gas Piping Outlets Boilers BTUs
Elevators/Escalators
LtL OTHER GAS PIPING I Heat Exchanger
Quantity of Outlets Pumps
#Vented Wall Furnaces Refrigerator Condenser BTUs
#Water Heaters Solar Collection Systems
Tanks (gallons)
Wells
L-,-, ,r, ,,.) (..-{ y-\..e___ 4 6... ,,,,,,,,,_____.,,,,
n 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 provisions of any other state or
local law regulation construction or the performance of construction. C
Owner Name: (� ,r� t Phone Number: /,,��
Mechanical Company: b-)cl # S€1V' �S o'� 'iv ' cIo✓� fice Phone: 9101 J-3) I `"`*�
Co. Address: t 1 / 6rdt-'72 (0`i'� fa City: ���P.. Kms" State: C-Cj Zip: 3`34g1
License Holder: ( r12,L.- (�t—CQ State Certification/Registration# L U l ,3
Notarized Signature of License Holder
The foregoi • strument was acknowledged before me this id dal) v0 (12(7in the State of Florida,
County of (_)V 0,,1 /
Signature of Notary Public
.� "`'° [ I Personally Known OR [ I Produced Identification
;�•. ••••fir.. TONIGINDLESPERGER
MY COMMISSION#HH 407122
T e of Identification: . _
�•. c: EXPIRES:October 6,2027 yp Updated 10/11/23