526 ATLANTIC BEACH CT ACRS18-0510 ACRS PERMIT MECHANICAL RESIDENTIAL HVAC PERMIT NUMBER
1# APERMIT ACRS18-0510
At; ISSUED: 12/28/2018
� k CITY OF ATLANTIC BEACH EXPIRES: 6/26/2019
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.
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.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
526 ATLANTIC BEACH CT MECHANICAL RESIDENTIAL HVAC - 3 A/C, 3 HVAC, $19500.00
HVAC TOTAL 7.5 TONS
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
169505 1410 ATLANTIC BEACH
COUNTRY CLUB UNIT 02
COMPANY: ADDRESS: CITY: STATE: ZIP:
A/C MASTERS HVAC INC 445 TRESCA ROAD #306 JACKSONVILLE FL 32225
OWNER: ADDRESS: CITY: STATE: ZIP:
RUMMANS ALBERT E JR 14 TURTLE RIDGE CT RIDGEFIELD CT 06877
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.
LIST OF CONDITIONS
Roll off container company must be on City approved list. Container cannot be placed on City right-of-way.
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
AC AND REFRIGERATION 455-0000-322-1000 7.5 $56.00
FURNACES AND HEATING 455-0000-322-1000 90000 $28.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.09
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
Issued Date: 12/28/2018 1 of 2
MECHANICAL RESIDENTIAL HVAC PERMIT NUMBER
ACRS18-0510
\.) — PERMIT ISSUED: 12/28/2018
CITY OF ATLANTIC BEACH EXPIRES: 6/26/2019
TOTAL:$143.09
Issued Date: 12/28/2018 2 of 2
MECHANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233 /� /a n c J V� , C
Ph(904)247-5826 Fax(904)247-5845 I A l�I�.J I fl s /'� Q
JOB ADDRESS: Sc) A-4 'Qel�i L �e (1 Cct_,✓ 4- PERMIT# R —0)O
PROJECT VALUE$ 1500
NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity 3 Tons Per Unit ),. 3
Heat: Unit Quantity 3 BTU's Per Unity 000 3t,60 Seer Rating I
Duct Systems: Total CFM 3 00 0 36,0�0 REQUIRED
REPLACEMENT MR CONDITIONING & HEATING SYSTEM INSTALLATION
ARI#
Air Conditioning: Unit Quantity Tons Per Unit REQUIRED
Heat: Unit Quantity BTU's Per Unit Seer Rating
Duct Systems: Total CFM REQUIRED
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 i J e Y'S i Jt 1 ( -,e S Phone Number
Mechanical Company ,i nq iV C s]-G� "-I M �'n c Office Phone-)Z4619:1 Fax -7.);49P
Co. Address: "1 4� rt Seg.. k o a�1 Sic; �t J Ub City Ji c l,Sp n J; i 1 t State It--CAC
. ) J-1
License Holder(Print): CL,k c. C rr...6 -tat•.y� , • '.=:'stration# CA{I d ) 3 65 l
Notarized Signature of License Holder �r 1,� '—U
Sworn and subscribed before me =26M day I • er"...t;, 20 ii
;Ar."" ,; DEBRA ANN H0181NGTON
MY COMMISSION x G0031926Signature of Notary Publico_ •
EXPIRES October 16,2020 /
Sy,
st' Cash Register Receipt Receipt Number
City of Atlantic Beach R7718
'r ;37��
DESCRIPTION ACCOUNT I QTY PAID
PermitTRAK $143.09
ACRS18-0510 Address: 526 ATLANTIC BEACH CT APN: 169505 1410 $143.09
MECHANICAL $139.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
AC AND REFRIGERATION 455-0000-322-1000 8 $56.00
FURNACES AND HEATING 455-0000-322-1000 90000 $28.00
STATE SURCHARGES $4.09
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.09
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL FEES PAID BY RECEIPT: R7718 $143.09
CITY G ATLANTIC BEACH
800 SENINOLE RD
ATLANTIC =AC,FL 32233
12,28 2018
CREDIT CARD 08:08:53
MC SALE
Card
SEQ 4: XXXXXXXY(XXX9016
Batch rr: 1
INVOICE 760
Approval Code: 1
Entry Method: 03632E
Mode: Manual
Tax Amount: Online
Card Code: $0,00
SALEAMOUNT $143,09
CUSTOMER COPY
Date Paid: Friday, December 28, 2018
Paid By: A/C MASTERS HVAC INC
Cashier: BA
Pay Method: CREDIT CARD 1
Printed: Friday, December 28,2018 8:09 AM 1 of 1
muu�