1011 Atlantic Blvd. - Mech HVAC Only CITY OF ATLANTIC BEACH
J 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
MECHANICAL HVAC PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247 -5814
JOB INFORMATION:
Job ID: 16- MECH -30
Job Type: MECHANICAL HVAC ONLY
Description: HVAC - 1 AC, 1 AHU, 4 TON
Estimated Value: $6,000.00
Issue Date: 1/6/2016
Expiration Date: 7/4/2016
PROPERTY ADDRESS:
Address: 1011 ATLANTIC BLVD
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: COOL CLIMATE HEATING AND A/C
Address: 3653 REGENT BLVD EAST PARK QA ROBER GUTZWILLER
Phone: 904 - 641 -9307
PERMIT INFORMATION: Sticker for overcurrent protection must be on A/C equipment prior to
inspection. Failure to comply will result in a failed inspection and reinspect fees. No
exceptions.
FEES:
Furnaces and Heating $24.00
AC and Refrigeration $32.00
State Mech DBPR Surcharge $2.00
State Mech DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $115.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
MECHANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph (904) 247 -5826 Fax (904) 247 -5845 1 (, — -
JOB ADDRESS: / 0 // 1 Hc. ) /G(' PERMIT #
PROJECT VALUE $ ` U UU - G U ARI # 2 3 y C 3 7 REQUIRED
Air Handling Equipment Only Air Handling Unit & Condenser Condenser Only
NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity Tons Per Unit
Heat: Unit Quantity BTU's Per Unit Seer Rating
Duct Systems: Total CFM REQUIRED
REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity / Tons Per Unit y
Heat: Unit Quantity BTU's Per Unit to ) 000, Seer Rating
Duct Systems: Total CFM !WOW REQ IRED
FIRE PREVENTION
Fire Sprinkler System Quantity (Requires 3 sets of plans)
Fire Standpipe Quantity (Requires 3 sets of plans)
Underground Fire Main Value (Requires 3 sets of plans)
Fire Hose Cabinets Quantity (Requires 3 sets of plans)
Commercial Hoods Quantity (Requires 3 sets of plans)
Fire Suppression Systems Quantity (Requires 3 sets of plans)
FIRE PLACES MISCELLANEOUS:
Prefabricated Fireplace Qty Automobile Lifts
Gas Piping Outlets Boilers BTU's
Elevators/Escalators
ALL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets Pumps
# Vented Wall Furnaces Refrigerator Condenser BTU's
# Water Heaters Solar Collection Systems
Tanks (gallons)
Wells
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.
Property Owners Name ES v -'y () Yl e- Phone Number 9 ` � _a 9 a -Z 2 2 Z
Mechanical Company ro c) 1 / / CJ,/'lc. f Office Phone 6 Y/ - 93 0 'ax 6y/
Co. Address:
GS re. e o� 1. ? ° ) City T✓�"�e State )� Zip / Zi -1 Y
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License Holder (Print): F O\, v L (- w - t It State Certification/Registrahon #"/ g/ V S
7
Notarized Signature of License Holder , rL
Before me this day of 20
Signature of Notary Public