465 Island Dr ACRS22-0045 HVAC Mechanical Permit A lication "ALL INFORMATION
pp HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 r\L RS"Zz _Q:/�
Phone: (904) 247-582216 Email: Building-Dept@coab.us PERMIT#:
i
JOB ADDRESS: q1, .� 4
s G.+I PROJECT VALUE$ "IS
F-1 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 /•S
Heat: Unit Quantity�L_ BTU's Per Unit /1~ Seer Rating(REQUIRED) JY
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
Elevators/Escalators
[—]ALL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets Pumps
#Vented Wall Furnaces Refrigerator Condenser BTUs
#Water Heaters Solar Collection Systems
Tanks (gallons)
Wells
OTHER:
Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months. thereby
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: a,l, A/, Phone Number: 1/07. Z62, if
Mechanical Company: -. Cin J�" r"'/�r Office Phone: 37z - 9j79 Fax
Co.Address: x/.ef /, 5-r( /✓, City: Ove ems- State: Ate— Zip: 3 Zz^Sd
License Holder: Stat Certification/Registration# C/]-G/d14B a3➢
Notarized Signature Of License Holder )'
The foregoing iriqTtkp1ent walacknowledged before me this of ,2 L7yw tl a State of Florida,
County of `Pub/n
Signature of Notary Public ,�.
Ale
TOM GINDIESPERGER personally Known OR[ ] Produced Identification
NyCOLUSslogacG3n3Type of Identification:
'Y'IRES:Ddobw6,2023 Updated 10/9/18
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