168 SEMINOLE RD ACRS22-0420 COAB Permit Form with ConditionsOWNER:ADDRESS:CITY:STATE:ZIP:
PATRIDGE HAYLEY 168 SEMINOLE RD ATLANTIC BEACH FL 32233
COMPANY:ADDRESS:CITY:STATE:ZIP:
J & W HEATING AND AIR 5011 Sunbeam Road JACKSONVILLE FL 32257
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
170595 0000 SALTAIR SEC 01
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
168 SEMINOLE RD MECHANICAL RESIDENTIAL
HVAC HVAC - 1 A/C, 1 AHU, 3 TON $7100.00
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
AC AND REFRIGERATION 455-0000-322-1000 3 $24.00
FURNACES AND HEATING 455-0000-322-1000 36000 $24.00
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
TOTAL: $107.00
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
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.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT
IN 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.
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.
1 of 2Issued Date: 12/30/2022
PERMIT NUMBER
ACRS22-0420
ISSUED: 12/30/2022
EXPIRES: 6/28/2023
MECHANICAL RESIDENTIAL HVAC
PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $107.00
ACRS22-0420 Address: 168 SEMINOLE RD APN: 170595 0000 $107.00
MECHANICAL $103.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
AC AND REFRIGERATION 455-0000-322-1000 3 $24.00
FURNACES AND HEATING 455-0000-322-1000 36000 $24.00
STATE SURCHARGES $4.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL FEES PAID BY RECEIPT: R21966 $107.00
Printed: Friday, December 30, 2022 2:08 PM
Date Paid: Friday, December 30, 2022
Paid By: J & W HEATING AND AIR
Pay Method: CREDIT CARD 779194374
1 of 1
Cashier: TG
Cash Register Receipt
City of Atlantic Beach
Receipt Number
R21966
ACRS22-0420