2213 Alicia Ln GSRS22-0072 Permit MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
GSRS22-0072
PERMIT
" ISSUED: 10/5/2022
rt'y" CITY OF ATLANTIC BEACH EXPIRES:4/3/2023
INSPECTIONMUST CALL • • , FOR NEXT DAY INSPECTION.
• F• . . . • 1 • • .
CODE, OF ATLANTIC BEACH CODEOF • .
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.
O. err • r • OF WORK:
2213 ALICIA LN MECHANICAL RESIDENTIAL GAS GAS PIPING -ONE OUTLET $1500.00
FOR FIREPLACE
TYPE OF REALESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP: I -
169519 0750 TIFFANY BY THE SEA
ADDRESS:
Hunter Gas 4770 Sandy Run Ln Jacksonville FI 32224
ADDRESS: CITY: STATE: ZIP:
DENNIS MANAGEMENT 1490 BENT CREEK DR SOUTHLAKE TX 76092
TRUST
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IP
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-COW 322-10M 1 $1000
MECHANICAL BASE FEE 455-WW-322-TOW 0 $5500
STATE DEEP SURCHARGE 4554)006208-0700 0 $100
STATE DCA SURCHARGE 455-0000308-Ofi00 0 $100
TOTAL:$69.00
Issued Date:10/5/2022 1 oft
ON
Mechanical Permit Application HIGHLIGHTEDIN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, Fl.32233
" Phone: (904) 2447-5826 Email: Building-Deptna coatIms PERMIT M.C)S RSZ2-0(D7
JOB ADDRESS:�� I- , ! / —e PROJECT VALUE$ I \ '
❑NEW AIR CONDITIONING &HEATING SYSTEM INSTALLATION ARI N(REQUIRED)
❑Air Handling Equipment Only ❑ Condenser Only ❑Air Handling Unit& Condenser
Air Conditioning: Unit Quantity Tons per Unit
Heat: Unit QuantityBTUs 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
❑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)
Fir Suppression Systems Quantity (Requires 3 sets of plans)
IRE PLACES ❑MISCELLANEOUS:
Prefabricated Fireplace(Qty)_ Automobile Lifts
Gas Piping Outlets I Boilers BTUs
Elevators/Escalators
❑ALL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets —A*.— Pumps
#Vented Wall Furnaces Refrigerator Condenser BTUs
#Water Heaters Solar Collection Systems
Tanks(gallons)
Wells
r—IOTHER:
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. q qV(� a]-I
Owner Name: Ow 1), L nL/t� )r +� Phone Number: lu- sty
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Mechanical Company: -- I,Cr Office Phone: Fax
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Co.Address: U nnZ Q City:�'-1,\%G,ru..\C State: - Zip: 32 LZI'
License Holder: �/� L St a Certification/Registration# Ica 1l � -
Notarized Signature of License Holder
The foregoing�s Iment was"a'qykp/knowil ore me this day n the tate of Florida,
County of tJl )x/'a �i Signature of Notary Publit
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�rsonally Known OR[ ] Produced Identification
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ESPERGER Type Of Identification: upO woio/9pe
hq GG 3631]8
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