527 ATLANTIC BEACH CT - GAS PIPING - rs' "l ''./ MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
PERMIT
GSRS19-0045
{ ` ISSUED: 5/16/2019
3 CITY OF ATLANTIC BEACH EXPIRES: 11/12/2019
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:
GAS PIPING - WATER
527 ATLANTIC BEACH CT MECHANICAL RESIDENTIAL GAS HEATER, STOVE, FIRE PLACE, $0.00
DRYER & GRILL
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
169505 1415 ATLANTIC BEACH
COUNTRY CLUB UNIT 02
COMPANY: ADDRESS: CITY: STATE: ZIP:
AEI INTERNATIONAL CORP. 7709 ALTON AVE JACKSONVILLE FL 32211
OWNER: ADDRESS: CITY: STATE: ZIP:
MICHAEL AND HOLLY 1661 ATLANTIC BEACH DR ATLANTIC BEACH FL 32233
IZARD
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 3 $10.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.78
Issued Date: 5/16/2019 1 of 2
01A, . , MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
ii
r ,� `. • PERMIT GSRS19-0045
.51 ISSUED: 5/16/2019
_rit
,� CITY OF ATLANTIC BEACH EXPIRES: 11/12/2019
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
VENTED WALL FURNACE WATER HEATER UNIT 455-0000-322-1000 2 $10.00
WORK WITHOUT PERMIT 455-0000-322-1000 0 $110.00
TOTAL:$189.78
Issued Date: 5/16/2019 2 of 2
**ALL INFORMATION
�t�;+r�� Mechanical Permit Application• HIGHLIGHTED IN
�;� � GRAY IS REQUIRED.
City of Atlantic Beach Building Department
Nr / 800 Seminole Rd, Atlantic Beach, FL 32233 GSRS19
(jo4S
"9''' Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:
JOB ADDRESS: 527 Atlantic Beach Ct PROJECT VALUE $
[]NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION AR!##(REQUIRED)
0 Air Handling Equipment Only 0 Condenser Only 0 Air Handling Unit& Condenser
Air Conditioning: Unit Quantity Tons per Unit Seer Rating (REQUIRED)
Heat: Unit Quantity BTUs per Unit
Duct Systems: Total CFM
❑REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION AR!#(REQUIRED)
0 Air Handling Equipment Only 0 Condenser Only 0 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) b,.
❑FIRE PLACES ❑MISCELLANEOUS:
Prefabricated Fireplace (Qty) Automobile Lifts
Gas Piping Outlets 1 Boilers BTUs
Elevators/Escalators
❑ALL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets 3 Pumps
#Vented Wall Furnaces Refrigerator Condenser BTUs
# Water Heaters 1 Solar Collection Systems
Tanks (gallons)
Wells
OTHER: Gas piping to watertieater,cooktop,firepalce,dryer and grill.
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.
Owner Name:Dostie Homes Phone Number:pimp
Aei Intl CorpBA AEI Gas Services 724-9771 ".7'.:•, Fax 721-3350
Mechanical Company: p Office Phone:
Co.Address: 7709 Alton Ave City: Jacksonville State: FL Zip: 32211
License Holder: Belinda Spradlin Q � p State Certification/Registration# 9917
U
Notarized Signature of License Holder C�i 44��� .SIJ {{��
The forego instrum nt was acknowledged before me this#lv-t ay of if ` , 20 Cr the State of Florida,
County of �[ gNotary h`t,^ ,& L� ��� �—P, �J
Sin ure of Public ^t, \.,, S� l tom`—'
Notary Public State of Florida `�
Stephanie E Carter [ Personally Known OR [ ] Produced Identification
•
+�4 : MyCommicsion GG 239425 Type of Identification:
�a M1� Expires 0 711 812 0 2 2
Updated 10/9/18
��i ,y,
. '� Cash Register Receipt Receipt Number
1 City of Atlantic Beach R9070
\o;i U'
DESCRIPTION I ACCOUNT I QTY I PAID
PermitTRAK $189.78
GSRS19-0045 Address: 527 ATLANTIC BEACH CT APN: 169505 1415 $189.78
MECHANICAL $75.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
GAS PIPING OUTLETS 455-0000-322-1000 3 $10.00
VENTED WALL FURNACE WATER HEATER
455-0000-322-1000 2 $10.00
UNIT
STATE SURCHARGES $4.78
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.78
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
WORK WITHOUT PERMIT $110.00
WORK WITHOUT PERMIT 455-0000-322-1000 0 $110.00
TOTAL FEES PAID BY RECEIPT: R9070 $189.78
Date Paid: Thursday, May 16, 2019
Paid By: AEI INTERNATIONAL CORP.
Cashier: CT
Pay Method: CREDIT CARD 016048
Printed:Thursday, May 16, 2019 4:28 PM 1 of 1
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