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1702 Atlantic Beach Dr GSRS19-0044 gas permit MECHANICAL RESIDENTIAL GAS PERMIT NUMBER s� PERMIT GSRS19-0044 ISSUED: 5/10/2019 CITY OF ATLANTIC BEACH EXPIRES: 11/6/2019 MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION. ALL ! •K MUST CONFORM TO THE CURRENT 6TH EDITION1 OF • ! + BUILDING CODE, NEC, IPMC, AND CITY OF ATLANTIC + CH CODE OF ORDINANCES . ALL i ! i OF PERMIT APPLY, PLEASE READ + 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: PERMITTYPE: DESCRIPTION: VALUE OF WORK: 1702 ATLANTIC BEACH DR MECHANICAL RESIDENTIAL GAS install gas-piping outlet & $17417.42 pre-fab gas fireplace TYPE OF • • GROUP: 169505 1700 ATLANTIC BEACH COUNTRY CLUB UNIT 02 • • . ADDRESS:-- CITY: STATE: ZIP: CAMPBELL PLUMBING AND MECHANICAL 6225 POWERS AVENUE JACKSONVILLE FL 32217 • + ! • • STATE: SPRENGER THOMAS A 1702 ATLANTIC BEACH DR ATLANTIC BEACH FL 32233 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 GAS PIPING OUTLETS 455-0000-322-1000 1 $10.00 MECHANICAL BASE FEE 45S-0000-322-1000 0 $55.00 PREFABRICATED FIREPLACES 455-0000-322-1000 1 $30.00 STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00 Issued Date: 5/10/2019 1 of 2 MECHANICAL RESIDENTIAL GAS PERMIT NUMBER PERMIT GSRS19-0044 ISSUED: 5/10/2019 CITY OF ATLANTIC BEACH EXPIRES: 11/6/2019 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00 TOTAL:$99.00 Issued Date:5/10/2019 2 of 2 **ALL INFORMATION Mechanical Permit Application ALLHIGINFORMATION GHTED I j0 City of Atlantic Beach Building Department GRAY IS REQUIRED. `. 800 Seminole Rd, Atlantic Beach, FL 32233 Cj 5 la b0 L(C fi �1{tv~ Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#- ACC 19-0019 JOB ADDRESS: 1702 Atlantic Beach Drive PROJECT VALUE$ 1�' ��"• �{a. ❑NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI#(REQUIRED) ©Air Handling Equipment Only El Condenser Only 0 Air Handling Unit& Condenser Air Conditioning: Unit Quantity Tons per Unit Heat: Unit Quantity BTUs per Unit Seer Rating (REQUIRED) Duct Systems: Total CFM F7 REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI#(REQUIRED) El Air Handling Equipment Only El Condenser Only p 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 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) F,—/]FIRE PLACES r7 MISCELLANEOUS: Prefabricated Fireplace (Qty)1 Automobile Lifts Gas Piping Outlets 1 Boilers BTUs Elevators/Escalators ❑ALL OTHER GAS PIPING Heat Exchanger Quantity of Outlets Pumps #Vented Wall Furnaces Refrigerator Condenser BTUs #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 1 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. Owner Name:Keith Campbell Phone Number: (904)376-5880 Mechanical Company: Campbell Plumbing&Mechanical Southeast Office Phone: (904)387-9996 Fax(904)387-9068 Co. Address: 6225 Powers Avenue City: Jacksonville State: FL Zip: 32217 License Holder: Keith Campbell State Certification/Registration# FL CMC 1250524 Notarized Signature of License Holder ti The foregoing instrum nt was acknowledged before me this fday o ,20A, in the State of Florida, County of �v :1ct� Signature of Notary Public ,OffPe` Notary PutAic State of Florida (VI Personally Known OR [ ] Produced Identification r+ gonna G Barrow Type of Identification: 'Y My Commission GG 181120 ?or , Expires 01/30/2022 Updated 10/9/18 a. t 1'0 ir -pis 1 J{ Wil �y`3' av,.s°• ! '!,'•`k� "r 5 1'f x $ r}gyp Atex-• �' j'' _ S 'Rt t>•rr}4p ice•* ... F Y d 4 < ¢ • .�, 24 0' }r .:;W A"t it ' • _ a � ��_ J ' r�y: 31 � �4 t� •.. •�calq py `� L 4.IA >"�' �.,./ iA1t { ,., Mfr^ rhk. 1•. 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'tp y 1 tt`h s$' 9'F x 9' ems, -= L'�A h•.s 4 y "�. �,� � ,}v J1' Y. r r . ° 'F`�`�'} k ^�4'.f ,.tl4 Yv t f.� S�• :.P� d,.... !-"�7 - ,: t"` r�•. 1!G �x yr t 3 tv � i. . x ° A �V '�; - u F r M � Yrs��x � 7i-'M � '��» •�tN .14 g •'�'"°r "S/ li 4 . t #,L�_95,�F f "�.6 � �,,;,°!� e9 .. saB� _'1 �< �.'i � �. i�' 7(i. ,��. g s•t,.�i �� _ ' w y r c rz try i wp <�.> Av F yarta y J r ,e 2' a "A54l • �t � ` ! ."a , ri �rt,w#!s1 p�€,r�11 r� A�� '^Ae „+, n� � S asp `Ms•` ¢ s` .e r Aow 'P'k .� rt - F .r0, ^� �v r . �� t� �'^ �, v •yk w Sy � � Y�t �` lfd it"+1 ♦ C �� r� rti aAs iN�"� 3y F k7i1• ! "Y'aG P x z, fi,e axa'2 ' ar tl 3 v may, kn, '''° • ^' � .f � �*�� F'�ay-• g w�+�ti; �4VI a 14 r• •i� . ; Tr�W niri,Fi!T`art�'f1s•..”."' ���'�#�.. a R t W s ( ��<T`M� F ui�FgGFr'AY�. �`e+R+i.`3•.1�,' r�si,t'' y°P � t �`� A� � �Jr�i'g`�/,. fgVF�3f•'.�w,,u�•fit ye ' j,F� � 34:. ;r� �� �•,N �^�' r...d �,•i .J� f rrY'A' Y �"a`� ')ff`y���i F-t',.-q y •S�LJr r Receiptister sl Cash • City ofAtlanticBeach DESCRIPTION • CITY PAID PermitTRAK $99.00 GSRS19-0044 Address: 1702 ATLANTIC BEACH DR APN: 169505 1700 $99.00 MECHANICAL $95.00 GAS PIPING OUTLETS 455-0000-322-1000 1 $10.00 PREFABRICATED FIREPLACES 455-0000-322-1000 $30.00 MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00 STATE SURCHARGES4.0 $ 0 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: R9019 $99.00 Date Paid: Friday, May 10, 2019 Paid By: CAMPBELL PLUMBING AND MECHANICAL Cashier: CT Pay Method: CREDIT CARD 06171G Printed: Friday,May 10,2019 3:22 PM 1 of 1 mwrr