1841 ATLANTIC BEACH DR GSRS25-0032 Permit Form with ConditionsOWNER:ADDRESS:CITY:STATE:ZIP:
BRZEZICKI GRZEGORZ 1841 ATLANTIC BEACH DR ATLANTIC BEACH FL 32233
COMPANY:ADDRESS:CITY:STATE:ZIP:
Hunter Gas 4770 Sandy Run Lane North Jacksonville Fl 32224
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
169505 1535 ATLANTIC BEACH
COUNTRY CLUB UNIT 02
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
1841 ATLANTIC BEACH DR MECHANICAL RESIDENTIAL GAS GAS PIPING - 1 OUTLET - SPA
HEATER $1400.00
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: 4/29/2025
PERMIT NUMBER
GSRS25-0032
ISSUED: 4/29/2025
EXPIRES: 10/26/2025
MECHANICAL RESIDENTIAL GAS
PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
2 of 2Issued Date: 4/29/2025
PERMIT NUMBER
GSRS25-0032
ISSUED: 4/29/2025
EXPIRES: 10/26/2025
MECHANICAL RESIDENTIAL GAS
PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
SIGNATURE OF CONTRACTOR
Mechanical Permit Application 02.25.2025
PRINT OR TYPE NAME OF CONTRACTOR DATE
MECHANICAL PERMIT APPLICATION
City of Atlantic Beach Building Department
800 Seminole Road, Atlantic Beach, FL 32233
Phone: (904)247-5826 Email: Building-Dept@coab.us
JOB ADDRESS PROJECT VALUE $
NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI # (REQUIRED)
Air Handling Equipment Only Condenser Only
Air Handling Unit & Condenser
Air Conditioning:
Heat:
Duct Systems:
Unit Quantity
Unit Quantity
Total CFM
Tons per Unit
BTU's per Unit
Seer Rating (REQUIRED)
REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI # (REQUIRED)
Air Handling Equipment Only
Air Conditioning: Unit Quantity
Condenser Only Air Handling Unit & Condenser
Tons per Unit
Heat:
Duct Systems:
Unit Quantity
Total CFM
BTU's per Unit
Seer Rating (REQUIRED)
FIRE PREVENTION
Fire Sprinkler System
Fire Standpipe
Underground Fire Main
Fire Hose Cabinets
Commercial Hoods
Fire Suppression Systems
Quantity
Quantity
Value
Quantity
Quantity
Quantity
(Requires 1 set of digital plans)
(Requires 1 set of digital plans)
(Requires 1 set of digital plans)
(Requires 1 set of digital plans)
(Requires 1 set of digital plans)
(Requires 1 set of digital plans)
ALL OTHER GAS PIPING
Quantity of Outlets
# Vented Wall Furnaces
MISCELLANEOUS
Generator
Gas Tanks
# Water Heaters Pre-fabricated Fireplace
Fireplace
Other:
Solar Collection Systems
NOTICE: Permit becomes expired if work does not commence within a six month period or work is suspended or abandoned for six
months. 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 OWNER Name Phone
MECHANICAL COMPANY Name
Phone
Address City State Zip
License Holder State Certification # Email
"In lieu of signed, sworn and notarized signatures of the property owner, agent and/or contractor, and under penalties of
perjury, I declare that I have read and examined the foregoing application and that the facts stated in it are true and correct."
FOR INTERNAL OFFICE USE ONLY
PERMIT #
**ALL information required to process
1841 Atlantic Beach Dr. 1400.00
1
Spa heater
Grzegorz Brzezick
Hunter Gas
2162589341
9043862172
4770 sandy run lane n. Jacksonville Fl.32224
Ryan Rodriguez Lq-31206 Ryan@huntergas.com
04/27/2025Ryan Rodriguez
GSRS25-0032