760 PLAZA ACRS22-0206 go,
s—,J,y Mechanical Permit Application **ALL INFORMATION
HIGHLIGHTED IN
"'' City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233
'%01119r Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:RQ RSZZ- OZOI
JOB ADDRESS: 1 v .P1.---K"2--1\-- 12V PROJECT VALUE$ ''.6.0100 V
n NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI#(REQUIRED)
❑ Air Handling Equipment Only ❑ Condenser Only VAir Handling Unit& Condenser
Air Conditioning: Unit Quantity Tons per Unit
Heat: Unit Quantity BTUs per Unit Seer Rating (REQUIRED)
Duct Systems: Total CFM
PREPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI#(REQUIRED)
Et-Air Handling Equipment Only ,erCondenser Only iAir Handling Unit& Condenser
Air Conditioning: Unit Quantity / Tons per Unit 2 -5 `�
_Heat: Unit Quantity / BTU's Per Unit z-Boor) Seer Rating (REQUIRED) /7 c �
Duct Systems: Total CFM ) bc)
❑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
Gas Piping Outlets Boilers BTUs
Elevators/Escalators
7ALL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets Pumps
#Vented Wall Furnaces Refrigerator Condenser BTUs
#Water Heaters Solar Collection Systems
Tanks (gallons)
Wells
n OTH ER:
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. p
Owner Name: a 1 LA— I. IAP,'f_e Phone/ rN�umber:`96 ifr<862•l}�a�
Mechanical Company: �t/t �M U l t11 t�tS I � C Office Phone: qO(�T°Sr3(O7 9 Fax
Co. Address: S73(, (b((C)r 1.14 City: ) I State:te' Zip: 4'''- t (
License Holder: (fit I 1.14 Vt A s State Certification/Registration# C AC / S/ '7 L 7,C
Notarized Signature of License Holder / �1//_
The foregoi gin rument w s acknowledged before me this i vday IP r,1 n ,, . Z,.in the State of Florida,
County of t)VQ
Signature of Notary Public O' AsTm.z`
TONI GINDLESPERGER •
F f,ri 4 : MY COMMISSION#GG 353178 [ ] Personally Known OR [ ] Produced Identification
`:.'! �..W EXPIRES:October 6,2023
ri '45.. FSO,'' BcndedfiruNoary Public Underwriters
Type of Identification:
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<:,r+sax.�:4%."•"`" 4 Updated 10/9/18