2020 Vela Norte Cir GSRS21-0108 1 Outlet (c(s
"r MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
A
PERMIT GSRS21-0108
�� .. ISSUED: 10/29/2021
CITY OF ATLANTIC BEACH
�u;a>%
EXPIRES: 4/27/2022
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: i DESCRIPTION: VALUE OF WORK:
Gas range piping to existing
2020 VELA NORTE CIR MECHANICAL RESIDENTIAL GAS $800.00
system
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
169506 1044 SELVA NORTE UNIT 01
COMPANY: ADDRESS: CITY: STATE: ZIP:
Hall's Gas Services, Inc. 3165 St Johns Bluff Rd S #8 Jacksonville FL 32246
OWNER: ADDRESS: CITY: STATE: ZIP:
TED L HAUSER 2020 VELA NORTE CIR ATLANTIC BEACH FL 32233
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT It
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.
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
GAS PIPING OUTLETS 455-0000-322-1000 1 $10.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$69.00
Issued Date: 10/29/2021 1 of 2
Mechanical Permit A lication **ALL INFORMATION
�� HIGHLIGHTED IN
'-./f.'' !
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 p f 1
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: rC U f n J 2I -Old
JOB ADDRESS: C c Cc /`, ,t --e c"•'' PROJECT VALUE $ /z-. 9
NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI#(REQUIRED)
❑ Air Handling Equipment Only ❑ Condenser Only ❑ Air Handling Unit& Condenser
Air Conditioning: Unit Quantity Tons per Unit
Heat: Unit Quantity BTUs per Unit Seer Rating (REQUIRED)
Duct Systems: Total CFM
I REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI#(REQUIRED)
❑ Air Handling Equipment Only ❑ Condenser Only ❑ 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)
FIRE PLACES MISCELLANEOUS:
Prefabricated Fireplace (Qty) Automobile Lifts
Gas Piping Outlets Boilers BTUs
rrtt,, Elevators/Escalators
I^IALL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets / Pumps
#Vented Wall Furnaces Refrigerator Condenser BTUs
#Water Heaters Solar Collection Systems
Tanks (gallons)
Wells
I 'OTHER: All G4s gi'„ P , lv -�C-s!� 5/S�r••-
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: I rC /141,,/—,----- Phone Number:
Mechanical Company: 1-4//s 6 -, -Sr-,, , 's, %,c_ Office Phone: 90,--)4p-"?a/4 Fax
Co. Address: 3047 S/. Jak6 b14.1-/,e C 413 City: S Or State: rc Zip: 3D)'-/‘
License Holder: .3-6's4,-i t //e%// State Certification/Registration# L1- 3)7 I
Notarized Signature of License Holder .—` ,
The foregoing instrument was acknowledged before me this 2.9 day of OCT_ , 2021, in the State of Florida,
County of D U VA ��� � _ D _
Signature of Notary Public ��!
CHRISTIANGILES
,,01;:k.,,� [ ] Personally Known OR [ Produced Identification
MY COMMISSION#HH 117153 Oro �` L -
Type of Identification:
..,er .P EXPIR&S1:'April
`1:3,�220,�255y
•''EOF ii�• Bonded Thru Notary Public tlf deV*Tkel Updated 10/9/18
i w
,sws