1816 Atlantic Beach Dr GSRS24-0100 PermitOWNER:ADDRESS:CITY:STATE:ZIP:
FREDERICK TABER ALBAN 1816 ATLANTIC BEACH ATLANTIC BEACH FL 32233
COMPANY:ADDRESS:CITY:STATE:ZIP:
Budget Services of NE FL 117 Broward Cove Rd FL
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
169505 1605 ATLANTIC BEACH
COUNTRY CLUB UNIT 02
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
1816 ATLANTIC BEACH DR MECHANICAL RESIDENTIAL GAS Gas line to Generator $500.00
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
GAS PIPING OUTLETS 455-0000-322-1000 1 $10.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $69.00
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property
that may be found in the public records of this county, and there may be additional permits required from other
governmental entities such as water management districts, state agencies, or federal agencies.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT
IN YOUR 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.
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORM TO THE CURRENT 6TH EDITION (2017) OF THE FLORIDA BUILDING
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
1 of 2Issued Date: 12/3/2024
PERMIT NUMBER
GSRS24-0100
ISSUED: 12/3/2024
EXPIRES: 6/1/2025
MECHANICAL RESIDENTIAL GAS
PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
2 of 2Issued Date: 12/3/2024
PERMIT NUMBER
GSRS24-0100
ISSUED: 12/3/2024
EXPIRES: 6/1/2025
MECHANICAL RESIDENTIAL GAS
PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $69.00
GSRS24-0100 Address: 1816 ATLANTIC BEACH DR APN: 169505 1605 $69.00
MECHANICAL $65.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
GAS PIPING OUTLETS 455-0000-322-1000 1 $10.00
STATE SURCHARGES $4.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL FEES PAID BY RECEIPT: R29168 $69.00
Printed: Tuesday, December 3, 2024 10:55 AM
Date Paid: Tuesday, December 03, 2024
Paid By: Budget Services of NE FL
Pay Method: CREDIT CARD 10373175931
1 of 1
Cashier: AG
Cash Register Receipt
City of Atlantic Beach
Receipt Number
R29168
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)
WellsL-,-, ,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 Ul 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 Identificationfir.. TONIGINDLESPERGER
MY COMMISSION#HH 407122 T e of Identification:
c: EXPIRES:October 6,2027 yp
Updated 10/11/23