2254 BAREFOOT TR GSRS22-0014 COAB Permit Form with ConditionsOWNER:ADDRESS:CITY:STATE:ZIP:
AWAD ZIAD 2254 BAREFOOT TRCE ATLANTIC BEACH FL 32233-4564
COMPANY:ADDRESS:CITY:STATE:ZIP:
Hall's Gas Services, Inc.3165 St Johns Bluff Rd S #8 Jacksonville FL 32246
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
169463 0594 OCEANWALK UNIT 02
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
2254 BAREFOOT TRACE MECHANICAL RESIDENTIAL GAS GAS PIPING - ONE OUTLET $900.00
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
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $69.00
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property
that may be found in the public records of this county, and there may be additional permits required from other
governmental entities such as water management districts, state agencies, or federal agencies.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT
IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORM TO THE CURRENT 6TH EDITION (2017) OF THE FLORIDA BUILDING
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
1 of 2Issued Date: 3/2/2022
PERMIT NUMBER
GSRS22-0014
ISSUED: 3/2/2022
EXPIRES: 8/29/2022
MECHANICAL RESIDENTIAL GAS
PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
Mechanical Permit Application ALL INFORMATION
e• HIGHLIGHTED IN
ke•• City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 CSRSZZ-00l"f
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:
JOB ADDRESS: c2 a c ' 8-,47,- lf'A4t- PROJECT VALUE$ 9G'a-
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 MISCELLANEOUS:
Prefabricated Fireplace (Qty) Automobile Lifts
Gas Piping Outlets Boilers BTUs
Elevators/Escalators
1K.ALL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets I Pumps
Vented Wall Furnaces Refrigerator Condenser BTUs
Water Heaters Solar Collection Systems
Tanks (gallons)
Wells
OTHER: C9 1s t-c9- r ,-r t
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: nn.--) fJw"o/ Phone Number: 9U`/-,7c7-1-//av
Mechanical Company: W4/r--c ...5 sr,-.c's,f^L Office Phone: 7o',- 7t.)—>"" Fax
Co. Address: 301/7 s4.'Ans bl11-, s '5 City: T,,x State: Fc Zip: 3°g`/I.
License Holder: .0-4-e'''. 1: Hp// State Certification/Registration# L.T 3a"'. /
Notarized Signatureof License Holder
The foregoi trume t w s acknowled before me thisZSa _ _$S 0 th- State of Florida,
County of V
Signature of Notary Public
Personally Known OR [ ] Produced Identification
G
Type of Identification:i!:1‘":; ;;',;,... TONI GINDLESPERGER
Updated 10/9/18Ak. •.,: MY COMMISSION#GG 353178
EXPIRES:October 6,2023n,.. Bonded TAru Notary Public Underwriters
3/2/22, 3:34 PM Cardknox Portal
https://portal.cardknox.com/transactions?endDate=2022-03-02 23%3A59%3A59&expandedRow=600942691&key=7&startDate=2022-02-23 00%3A0…1/2
CARD INFORMATION
Card type:Visa Card expiration:04/24
Card number:**** 0292 Cardholder name:
JASON E HALL , HALLS GAS SERVICES
BILLING INFORMATION
JASON E HALL , HALLS GAS SERVICES
3047 ST JOHNS RD BLUFF S # 3
JACKSONVILLE FL 32246
BUILDING-DEPT@COAB.US
-9047627016
CUSTOM INFORMATION
ADDITIONAL INFORMATION
Entry method:Keyed Reference Number:600942691
Payment type:Credit Card Authorization Code:08462G
AVS:Address: Match & 5 Digit ZIP: Match Service Fee:$1.99
Description:
GSRS22-0014 2254 BAREFOOT TRACE
SIGNATURE
X
PROCESSING INFORMATION
Amount $69.00
Date:3/2/2022 8:49:48 AM
Transaction type:Sale
Status:Approved
City of Atlantic Beach, Florida
800 Seminole Rd
Atlantic Beach FL 32233
904-247-5800
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $69.00
GSRS22-0014 Address: 2254 BAREFOOT TRACE APN: 169463 0594 $69.00
MECHANICAL $65.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
GAS PIPING OUTLETS 455-0000-322-1000 1 $10.00
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: R18910 $69.00
Printed: Wednesday, March 2, 2022 3:32 PM
Date Paid: Wednesday, March 02, 2022
Paid By: Hall's Gas Services, Inc.
Pay Method: CREDIT CARD 600942691
1 of 1
Cashier: TG
Cash Register Receipt
City of Atlantic Beach
Receipt Number
R18910