1770 MARITIME OAK DR GSRS22-0038 **ALL INFORMATION
;a`-.t171,;, Mechanical Permit Application HIGHLIGHTED IN
'' City of Atlantic Beach Building Department GRAY IS REQUIRED.
•v 800 Seminole Rd, Atlantic Beach, FL 32233 e SRS ZZ-6038
,x� pi.)-- Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:
JOB ADDRESS: fli 0 ���f `"'`c- OcAct 0C • PROJECT VALUE $ 4-1 j 3 • s
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
El 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 n MISCELLANEOUS:
Prefabricated Fireplace (Qty) Automobile Lifts
GPiping Outlets Boilers BTUs
Elevators/Escalators
ALL OTHER GAS PIPINGHeat Exchanger
Quantity of Outlets 1 _ (57tAirANJ r Pumps
#Vented Wall Furnaces Refrigerator Condenser BTUs
#Water Heaters Solar Collection Systems
Tanks (gallons)
Wells
f0THER:
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: ( 1./\ ML z f1c/CA1 Phone Number:
Mechanical Company: \.�n'ct( CTS Office Phone: o ko Fax
Co. Address: ��1 '„),")._\L,,._ Le N... , City: .c.l5)cnd•lt C State:
- Zip: )22Z'1
License Holder: Z.t-n ,oa
r: -4-Z-. ' State Certification/Regis tion# 9TH;- S 12�
Notarized Signature of License Holder � .
The foregoi g in trument w s acknowledge. •efore me •• ,a .f IA • 202- t e State of Florida,
County of D Y 1
Signature of Notary Public a.
;�o<,"'!?�c TONI GINDLESPERGER Xl Personally Known OR [ ] Produced Identification
s.: �,. .:,_; MY COMMISSION#GG 353178 Type of Identification:
4!'.3:' EXPIRES:October 6,2023 Updated 10/9/18
11F't?. Bonded Thru Notary Public Underwriters