1707 Beach Ave GSRS21-0119 Tank, OutletOWNER:ADDRESS:CITY:STATE:ZIP:
MALLOY JENNIE S 1707 BEACH AVE ATLANTIC BEACH FL 32233-5838
COMPANY:ADDRESS:CITY:STATE:ZIP:
AMERIGAS PROPANE LP
dba SAWYER GAS OF THE
BEACHES
855 TALLEYAND AVE JACKSONVILLE FL 32206
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
169660 0000 NORTH ATLANTIC BCH
UNIT 1
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
1707 BEACH AVE MECHANICAL RESIDENTIAL GAS GAS PIPING - 500LB TANK
AND ONE OUTLET $2000.00
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
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
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.
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.
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.
1 of 2Issued Date: 12/3/2021
PERMIT NUMBER
GSRS21-0119
ISSUED: 12/3/2021
EXPIRES: 6/1/2022
MECHANICAL RESIDENTIAL GAS
PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TANKS GAS OR LIQUEFIED PETROLEUM 455-0000-322-1000 1 $20.00
TOTAL: $89.00
2 of 2Issued Date: 12/3/2021
PERMIT NUMBER
GSRS21-0119
ISSUED: 12/3/2021
EXPIRES: 6/1/2022
MECHANICAL RESIDENTIAL GAS
PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $89.00
GSRS21-0119 Address: 1707 BEACH AVE APN: 169660 0000 $89.00
MECHANICAL $85.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
GAS PIPING OUTLETS 455-0000-322-1000 1 $10.00
TANKS GAS OR LIQUEFIED PETROLEUM 455-0000-322-1000 1 $20.00
STATE SURCHARGES $4.00
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: R18184 $89.00
Printed: Friday, December 3, 2021 10:14 AM
Date Paid: Friday, December 03, 2021
Paid By: AMERIGAS PROPANE LP dba SAWYER GAS OF THE BEACHES
Pay Method: CREDIT CARD 554902587
1 of 1
Cashier: CG
Cash Register Receipt
City of Atlantic Beach
Receipt Number
R18184
Mechanical Permit Application ALL INFORMATION
7"A`". sl HIGHLIGHTED INJ
TAP.,
r. ''\, City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233
i,"
r
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:
JOB ADDRESS: 1707 Beach Ave Atlantic Beach Florida 32233 PROJECT VALUE $2,000.00
NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI#(REQUIRED)
0 Air Handling Equipment Only 0 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
REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI#(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
7FIRE 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 7MISCELLANEOUS:
Prefabricated Fireplace (Qty) Automobile Lifts
Gas Piping Outlets Boilers BTUs
Elevators/Escalators
ALL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets 1 Pumps
Vented Wall Furnaces Refrigerator Condenser BTUs
Water Heaters Solar Collection Systems
Tanks (gallons) 500
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.
Owner Name:Eastern Shores Construction Phone Number: (904)545-7878
Mechanical Company: Sawyer Gas of the Beaches Office Phone: (904)271-9615 Fax
Co. Address: 98 Penman Road City: Jacksonville Beach State: FL Zip: 32250
License Holder: Justin Hayes State Certification/Registration # 30544
Notarized Signature of License Holder S HOLL,O/'''ii
7 (IA
The foreg instru ent was acknowledged before me this L U day of, 4-t 20 2A in th$St41. SF ;•:
county of ,.,, (Ci 4 i
Signature of Notary Public 4+ 60.0,4.4.„( * 2*
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