532 ATLANTIC BEACH CT - GAS PIPING V.9 CITY OF ATLANTIC BEACH
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;� 800 SEMINOLE ROAD
J ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
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MECHANICAL GAS PIPE PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-MCHG-2918
Job Type: MECHANICAL GAS PIPING
Description: GAS PIPING - 3 OUTLETS
Estimated Value: $1,090.00
Issue Date: 12/18/2015
Expiration Date: 6/15/2016
PROPERTY ADDRESS:
Address: 532 ATLANTIC BEACH CT
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: CONSTRUCTION SOLUTIONS &
Address: QA NONE - UNABLE TO QA NONE - UNABLE TO FIND
Phone: - -
FEES:
Gas Pipe Outlets $10.00
State Mech DBPR Surcharge $2.00
State Mech DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $69.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
JACKSONVILLE MECHANICAL PERMIT APPLICATION
S
JOB ADDRESS: 532 Atlantic Beach Ct PERMiIT#—rn C H -2918
*Pursuant to F.S. 553.721 & F.S. 468.631, a surcharge fee will be collected on any permit regulated under the FBC*
VALUE OF WORK $ 1 ,090
AIR CONDITIONING, HEATING & DUCTWORK INSTALLATION
Air Conditioning: Total Tons SEER/EER Rating
Heat: Number of Units
Duct Systems: Total CFM's
FIRE PREVENTION (Plan Review Required) OFFICE USE ONLY
, Fire Sprinkler System #of Heads (Submit 3 sets of plans)
Fire Standpipe Quantity (Submit 3 sets of plans) CROSS CONNECT FEE
Underground Fire Main Value $ (Submit 3 sets of plans)
0$35- Well, 2 inches or less
Fire Hose Cabinets Quantity (Submit 3 sets of plans)
Commercial Hoods Quantity (Submit 3 sets of plans) 0$200-Well, 2 inches or more
Fire Suppression Systems Value $ (Submit 3 sets of plans)
FIRE PLACES MISCELLANEOUS
Prefabricated Fireplace Qty Automobile Lifts
Gas Piping Outlets Qty 3 Boilers (BTU's)
Elevators/Escalators
ALL OTHER GAS PIPING Heat Exchanger
Gas Piping Outlets Qty Pumps
Vented Wall Furnace Qty Refrigerator Condenser(BTU's)
Water Heater Qty Solar Collection Systems
LP or Gas Tank (gallons)
WELL (Boundary Survey or Drawing detailing the following information is Required)
Purpose GPS Coordinates Latitude: Longitude:
ISize Diameter/Depth in x ft Well Casing Depth ft Well Casing Material
****SJRWD Well Completion Form to be submitted to the Building Department prior to final inspection ****
****Separate permit(s)required from Duval County****
OTHER
Permit becomes void if work is not done during six month period. 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.
Tenant Name (if applicable)
Property Owners Name Coastal Custom Homes of Ponte Vedra Phone Number (904) 303-3526
Mechanical Co. Name Construction Solutions and Supply Office Phone 389-2700 Fax 389-0277
E-Mail Address jromeka @bellsouth.net
Co. Address 5225 Edgewood Cou• City Jacksonville State FL Zip 32254
License Holder (Print): James]:''� / State Certification/Registration # 1331244
Notarized Signature of License Holder • `'
Affix Notary Seal Bel. NOTARY PUBLIC, STATE OF FLORIDA, COUNTY OF12%-
aP►«+• Notary Public State of Florida Sworn to (or affirmed) and subscribed before me this day of �, 20\5
Judy A Wilkerson ,
My Commission FF062698 i. ■� v7
aa/ Expires 05/02/2016 Notary Public Si:. ature
'iAlli'Notary Name: •� ' :.,..,D/Personally Known/Identification:
11 NORTH 3RD STREET PHONE(904)247-6235 FAX(. )247-6107 FBC 5"EDITION(2014) REVISED 6/30/15