83 Nicole Ln GSRS21-0122 Fireplace I-
,./,.... ,., MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
:-.a,; •� �� GSRS21-0122
J PERMIT ISSUED: 12/6/2021
.„/
CITY OF ATLANTIC BEACH
rTo1119%• EXPIRES: 6/4/2022
MUST CALL INSPECTIONYPHONE LINE (904) 247-5814 BY-4 PM FOR NEXT DAY INSPECTION.'4
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:
Fireplace: WOOD & STUCCO
83 NICOLE LN MECHANICAL RESIDENTIAL GAS REPAIR, WINDOW $2400.00
REPLACEMENT
TYPE OF REAL ESTATE ZONING• BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
169519 0825 TIFFANY BY THE SEA
COMPANY: ADDRESS: CITY: STATE: ZIP:
All Scale Plumbing 4320 Deerwood PKWY STE 101-117 Jacksonville Fl 32216
OWNER: ADDRESS: CITY: STATE: ZIP:
WALSH SUSAN 83 NICOLE LN ATLANTIC BEACH FL 32233-5979
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.
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
PREFABRICATED FIREPLACES 455 0000-322-1000 1 $30.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$89.00
Issued Date: 12/6/2021 1 of 2
rS'`' \JY��' MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
�, O . "' GSRS21-0122
` PERMIT
7;11, ISSUED: 12/6/2021
;, ,. CITY OF ATLANTIC BEACH EXPIRES: 6/4/2022
Issued Date: 12/6/2021 2 of 2
' ' YApplication **ALL INFORMATION
HIGHLIGHTED IN
n City of Atlantic Beach Building Department GRAY IS REQUIRED.
a
411. 800 Seminole Rd, Atlantic Beach, FL 32233
ojPhone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: Re- 3g t —0O2y0
JOB ADDRESS: 43 1 ,c-o/c in Iari-(G LGh P 3- ROJECT VALUE $ 7-2/rl /47V/On
I I 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 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 I I MISCELLANEOUS:
Prefabricated Fireplace (Qty) I Automobile Lifts
Gas Piping Outlets Boilers BTUs
Elevators/Escalators
BALL 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:
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: �Uc5 "? W 0,11-? Phone Number: !O5?!�/a 56g6
Mechanical Company: Al� SC-221 c Prvsn.6(y `l Office Phone: P0/3,A2 a30( Fax
Co. Address: ii3;10 DG /wOOe1/Q/f- it 1t
( ,City: ,� a,-- State:Fl Zip:ip34162/6
License Holder: ./(/l O/,�.f State ification/Registration# 6F' /4/1 9377
Notarized Signature of License Holder
The foregoing.in Yu ent was acknowledged before me this / day
�of�7°CG_ , 20 21, in the Florida,
County of L- /�6F r�
Signature of Notary PublicG % �.
:,:; CHRISTIAN GILES ( [ ] Personally Known OR [ Produced Identification
L
4, MY COMMISSION#HH 117153 I�
�� ay.= EXPIR6S:April 13,2025 Type of Identification: �� (✓ L
o,i Bonded Pau Notary RibliCUndenNdtets Updated 10/9/18