1091 Hibiscus ACRS22-0424 Permit Application ALL
* INFORMATIONMechanical Permit Application 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@coab.us PERMIT#: i�Ll RS ZZ-.--1Z4
JOB ADDRESS: ID-I/ /� 6,5")-5 J� PROJECT VALUE $ S°I q5r
❑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) 1G 7 8
❑ Air Handling Equipment Only ❑ Condenser Only ❑ Air Handling Unit& Condenser
Air Conditioning: Unit Quantity f Tons per Unit 19
Heat: Unit Quantity / BTU's Per Unit .?Y,ooa 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)
Fire Suppression Systems Quantity (Requires 3 sets of plans)
F-]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 provisions of any other state or
local law regulation construction or the performance of construction.
Owner Name: ��P�-� zy, / Phone Number: ' Odq*3d 7• SGDs
Mechanical Company: QGod�1il ,f�i,�/(a X'— Office Phone: 901'f;77- 9Y/� Fax
Co. Address: �Gy 1�1- SX Al City: �/ y 4- State: J�--E Zip:_?ZZ50
License Holder: State Certifi tion/Registration# G/�( ��/Y
Notarized Signature of License Holder
The foregoing instrumentvas acknowledged before me this-- day ` in the Sate of Florida,
County of �,:�_��" �,� r._ `
Signature of Notary Public
TONI GINDLESPERGER ersonally Known OR [ ] Produced Identification
Iy ,: MY COMMISSION#GG 353178 Type of Identification:
EXPIRES:October 6,2023
Bonded Thru Notary Public Underwriters Updated 10/9/18