616 Timber Bridge Ln GSRS22-0001 Outlet, Pool Heater s
01...ti MECHANICAL RESIDENTIAL GAS
PERMIT NUMBER
°�
•;,v' PERMIT GSRS22-0001
u ' ISSUED: 1/10/2022
'''<'1.-4_01119''___/ CITY OF ATLANTIC BEACH EXPIRES: 7/9/2022
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: DESCRIPTION: VALUE OF WORK:
616 TIMBER BRIDGE LN MECHANICAL RESIDENTIAL GAS 1 Outlet: SWIMMING POOL $1500.00
heater
TYPE OF REAL ESTATE BUILDING USE
CONSTRUCTION: NUMBER: ZONING: GROUP: SUBDIVISION:
169505 2095 ATLANTIC BEACH
COUNTRY CLUB UNIT 02
COMPANY: ADDRESS: CITY: STATE: ZIP:
Hunter Gas 4770 Sandy Run Ln Jacksonville FI 32224
OWNER: ADDRESS: CITY: STATE: ZIP:
SEAWELL MICHAEL R 616 TIMBER BRIDGE LN 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.
ES
Ailmaii.
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: 1/10/2022 1 of 2
fs "'�� MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
�rj
GSRS22-0001
PERMIT
ISSUED: 1/10/2022
CITY OF ATLANTIC BEACH EXPIRES: 7/9/2022
Issued Date:1/10/2022 2 of 2
LA,-,„, Mechanical Permit Application **ALL INFORMATION
*' HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
¢ W 800 Seminole Rd, Atlantic Beach, FL 32233
`ons) Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:
JOB ADDRESS: 6, ( Comet:,-0-,c_r (Sc•aV___ Ca.n.C.- • PROJECT VALUE $ 4(4,-,.... .--
1-7
('5 ., .--n 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
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
G2 -PipingOutlets 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
.(. .\-Ike,hc_S- 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: d„,< c�A.L Jt.�wel` Phone Number: 4o'-t316 R-1
Mechanical Company: ktv,‘t-c-r (Sc1' Office Phone: ... IVI-1C1L Fax
Co. Address: u'11v 5,,,1Z,vd."„, 14,,c_ )•.--)• City: d L.c.I .3fLLc_ State:�C .Zip: 322A
License Holder: ,t..,, ,A..ecl.�cL State Certification/Registration# `3 t2b CO .
Notarized Signature of License Holder r __
The foregoing ins tru ent was acknowledgedE fore m this 10 day of J/141\1 , 20�Z,in the State of Florida,
County of D ✓14'1� �
Signat re of Notary Public 6! / 4614
: �!""•.. CHRISTIAN GILES ] Personally Known OR [ IY ced Identification
+; s• " MY COMMISSION#HH 117153
..,_ �..., EXPIRES:Apr013,2025 pe of Identification: - {� - L_ -
",f.ffrO" Bonded Nu Notary public Undone/tars Updated 10/9/18