812 OCEAN BLVD - GSRS22-0050 rGSRS'%� MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
p ,'
22-0050
PERMIT
,ot" ISSUED: 7/15/2022
CITY OF ATLANTIC BEACH EXPIRES: 1/11/2023
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:
812 OCEAN BLVD MECHANICAL RESIDENTIAL GAS PRIVATE PROVIDER GAS $3000.00
PIPING 4 OUTLETS
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
170335 0000 PARK TERRACE
COMPANY: ADDRESS: CITY: STATE: ZIP:
ADVANCED VENTILATION 11519 DUNN CREEK RD JACKSONVILLE FL 32218
LLC
OWNER: I ADDRESS: CITY: STATE: ' ZIP:
REED DAVID E 10898 BRIDGES RD JACKSONVILLE FL 32218
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT If\
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.
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
GAS PIPING OUTLETS 455-0000-322-1000 2 $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
VENTED WALL FURNACE WATER HEATER UNIT 455-0000-322-1000 3 $15.00
Issued Date:7/15/2022 1 of 2
Mechanical Permit Application **ALL INFORMATION
; HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
,/ 800 Seminole Rd, Atlantic Beach, FL 32233 + - _ 1-'` 005
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:1Z c 21 -035-8#
JOB ADDRESS: � 2... D C rAi\J 'Q t v b Act, 37733 PROJECT VALUE $ 3 e b-0
❑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
[TREKACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI#(REQUIRED)
[l Air Handling Equipment Only 0 Condenser Only 0 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
[IFIRE 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 ri MISCELLANEOUS:
Prefabricated Fireplace (Qty) Automobile Lifts
Gas Piping Outlets Boilers BTUs
Elevators/Escalators
TALL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets 2 Pumps
#Vented Wall Furnaces 0 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. 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: ¶'P i V ?krc G D Phone Number: 9ocf /OO -3 q
Mechanical Company: Aa)A"ICCCI if e At-.Itit ,o,..► L•/- C- Office Phone: 90y c fa,380`f Fax
Co. Address: % S $'i 't)v.v, C,rsc lc .2d City: 71—"GIGso AAA)C State: FL zip:12?/Sri
License Holder: 12.,ICVNCtr GI ?c .351. 1State Certification/Registration# CAG Ig1 6 3 7 '7
Notarized Signature of License Holder
The foregoing instrunt was acknowledged before me this LC7 day of tri,L,! ,20).2, in the State of Florida,
Signature of Notary Public 4
i
/4:""A MELISSA A. MEJIA
i.: = MY COMMISSION#HH 231803 [ ] Personally Known OR [\Produced Identification
�..^t.•;;d-se EXPIRES:February 21.2026
•, ,,,‘�' Type of Identification: - L.- b�
Updated 10/9/18