631 Amberjack Ln ACRS22-0386 Permit MECHANICAL RESIDENTIAL HVAC PERMIT NUMBER
ACRS22-0386
PERMIT ISSUED: 11/21/2022
CITY OF ATLANTIC BEACH EXPIRES: 5/20/2023
INSPECTIONMUST CALL . r • FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORMTO THE CURRENT 6TH EDITION1 OF •
CODE, . CITY OF •DOF ORDINANCES .
ALL CONDITIONS or
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:
631 AMBERIACK LN MECHANICAL RESIDENTIAL HVAC - 1 A/C, 1 AHU, 2 TON $3832.00
HVAC
TYPE OF REALESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
171187 0000 ROYAL PALMS UNIT 01
COMPANY: ADDRESS:
Air Source America DBA 207 20th ST N JACKSONVILLE FL 32250
Buehler Air Conditioning BEACH
• ADDRESS:
UPCHURCH CHARLES B 631 AMBERIACK LN ATLANTIC BEACH FL 32233-4202
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT II`
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.
CONDITIONSLIST OF
Roll off container company must be on City approved list. Container cannot be placed on City right-of-way.
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
AC AND REFRIGERATION 4550000-322-1000 2 $16.00
FURNACES AND HEATING 455-0000-322-1000 24000 $2400
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
STATE DERR SURCHARGE 455-OW 208-07M 0 $2w
STATE DCA SURCHARGE 455-OW 208-06M 0 $2.00
Issued Date:11/21/2022 1 of 2
Mechanical Permit Application "ALL INFORMATION
PP HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: Building-Dept@cciab.Us PERMIT M: RCRSZZ"w�0
JOB ADDRESS: eat Amberiack Ln.A lantic Beach,FL 32233 PROJECT VALUE$3,832.00
El NEW AIR CONDITIONING&HEATING SYSTEM INSTALLATION ARI#(REQUIRED)
13 Air Handling Equipment Only El Condenser Only 0 Air Handling Unit&Condenser
Air Conditioning: Unit Quantity 0 Tons per Unit 0.0
Heat: Unit Quantity 0 BTUs per Unit 0 Seer Rating(REQUIRED)
Duct Systems: Total CFM 0
❑� REPLACEMENT AIR CONDITIONING&HEATING SYSTEM INSTALLATION ARI#(REQUIRED) 2Hesno
❑Air Handling Equipment Only O Condenser Only m Air Handling Unit& Condenser
Air Conditioning: Unit Quantity 1 Tons per Unit 2.a
Heat: Unit Quantity 1 BTU's Per Unit 2e,om Seer Rating(REQUIRED) 15.50
Duct Systems: Total CFM 0
r-1 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
❑ALL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets Pumps
#Vented Wall Furnaces 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 proviylons of any other state or
local law regulation construction or the performance of construction.
Owner Na me:Ohades Upchurch Phone Number: (902)µ-r723
Mechanical Company: Buehler"CoMificy, Office Phone: (04)233-8631 Fax(004)x86-0796
Co.Address: "72kh at City: dauvomau Beam State: FL Zip: 32255
License Holder: Jason Buehler State Certification/Registration# CAC 1515716
Notarized Signature of License Holder LdAl�
The foregoing IP�tru a t was acknowledged before me this ay of r J64�A 20�, 1a/n theState of Florida,
County of A Alyy\ Signature of Notary Publ q/ lo-41 M
Noun Fusee earaxn
ASMeyMxrup,pp Personally Known OR ]Produce Identlication
'R. e.w„o6x 0I`µ ype of Identification: D
ucdared20/18