374 2nd St GSRS23-0030 Permit MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
' GSRS23-0030
PERMIT ISSUED: 4/14/2023
CITY OF ATLANTIC BEACH EXPIRES: 10/11/2023
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORMTO THE CURRENTr • • OF • • rA BUILDING
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF AD
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:
374 2ND ST MECHANICAL RESIDENTIAL GAS GAS PIPING - 3 OUTLETS $1000.00
TYPE OF
ZONING: : r •
• • GROUP:
169773 0000 ATLANTIC BEACH
COMPANY: ADDRESS: CITY: STATE: ZI
Hall's Gas Services, Inc. 3165 St Johns Bluff Rd S #8 Jacksonville FL 32246
• err • CITY: STATE: ZIP:
TAYLOR ERNEST DEAN 667 GOOD SPRINGS RD BRENTWOOD TN 37027
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.
LIST OF . r •
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 3 $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
TOTAL: $69.00
Issued Date:4/14/2023 1 of 2
:t= Mechanical Permit Application **ALL INFORMATION
HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
Z 800 Seminole Rd, Atlantic Beach, FL 32233 C-\Sj<-, S Z3-003 U
O1i9r Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: PPl a�-dooms
JOB ADDRESS: 374/ :2,.1 Sf, PROJECT VALUE$ /Ooo.
❑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)
❑ 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)
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 oZ 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: L c) Phone Number:
Mechanical Company: H4/1,5 j, Office Phone: -;�vW6 Fax
Co. Address: 3/6City: State: f6 Zip: 3�a�r6
License Holder: sw f' 14.7 State Certification/Registration#
Notarized Signature of License Holder
The foreg 'ng' strum nt as acknowledged before me this day f n the State of Florida,
County of� l� 71Qv
-
Signature of Notary Public
: �P�e�•.; T0141GINDLESPERGERPersonally Known OR [ ] Produced Identification
MY COMMISSION#GG 353178
Type of Identification:
EXPIRES:October 6,2023
+r•.,,,.•'e`• Updated 10/9/18
Bonded Thru No:ary Public Underwriters