1957 Seminole Rd ACRS22-0212 COAB Permit Form with ConditionsOWNER:ADDRESS:CITY:STATE:ZIP:
NICHOL WILLIAM 1957 SEMINOLE RD ATLANTIC BEACH FL 32233
COMPANY:ADDRESS:CITY:STATE:ZIP:
OCEAN STATE HEAT & AIR,
INC.1476 ATLANTIC BLVD NEPTUNE BEACH FL 32266
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
169542 0512 BEACHSIDE
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
1957 SEMINOLE RD MECHANICAL RESIDENTIAL
HVAC HVAC - 1 A/C, 1 AHU, 4 TON $8206.00
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
AC AND REFRIGERATION 455-0000-322-1000 4 $32.00
BUILDING PERMIT RENEWAL 455-0000-322-1000 0 $226.53
FURNACES AND HEATING 455-0000-322-1000 48000 $24.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $3.32
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: 5/25/2023
PERMIT NUMBER
ACRS22-0212
ISSUED: 5/25/2023
EXPIRES: 11/21/2023
MECHANICAL RESIDENTIAL HVAC
PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.21
WORK WITHOUT PERMIT 455-0000-322-1000 0 $110.00
TOTAL: $453.06
2 of 2Issued Date: 5/25/2023
PERMIT NUMBER
ACRS22-0212
ISSUED: 5/25/2023
EXPIRES: 11/21/2023
MECHANICAL RESIDENTIAL HVAC
PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
Obi (.2_,s0[Ltq
r> -,/,. Mechanical Permit Application ALL INFORMATION
City of Atlantic Beach Building Department HIGHLIGHTED
YREQUIRED.E
J‘ J GRAY IS REquIRED.800 Seminole Rd Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email:Building-Dept
Ll S ZZ 02 ( Z
G071. US PERMIT
JOB ADDRESS: 1 9S- 3-e • tt, 1))0cul PROJECT VALUE$.....
oDU
0 NEW AIR CONDITIONING &HEATING SYSTEM INSTALLATION ARI#(REQUIRED)0 Air Handling Equipment Only IRED1
Air Conditioning: Unit Quanti Tons
Condenser Only 0 Air Handling Unit& CondenserNeat: ons per UnitUnitQuantity_ _ BTUs per UnitDuSystems:Total CFM Seer Rating (REQUIRED)I
EPLACEMENT AIR CONDITIONING&HEATING SYSTEM INSTALLATION ARI#1(REQUIRED)0 Air Handling Equipment Only 1 p Condenser OnlAirConditioning: Unit Quantityy 0 Air Handling Unit& Condenser
Heat: Unit
Tons per Unit Li{ -i-Ly)
I I-Quantity__;_____i___ BTU's Per Unit ( C.)00 Seer Rating(REQUIRED)lpDuctSystems:Total CFM
OFIRE PREVENTION
Fire Sprinkler System QuantiFireStandpipe Requires 3 sets of plans)
Underground Fire Main
Quantity 1 Requires 3 sets of plans)
Fire Cabinets
Value Requires 3 sets of plans)Fire Hoselal Hoods
Quantity I Requires 3 sets of plans)Quantity Requires 3 sets oflansFireSuppressionSystemsQuantityRequiresp )
3 sets of plans)
FIRE PLACES
Prefabricated Fireplace (Qty)
El MISCELLANEOUS:
I Automobile LiftsGasPipingOutlets
Boilers BTUs
CALL OTHER GAS PIPING Elevators/Escalators
I Heat ExchangerQuantityofOutletsPumps
if vented Wall Furnaces
Water Heaters Refrigerator Condenser BTUs
Solar Collection Systems
Tanks (gallons)
I Wells
OTHER:
Permit becomes void if work does not commence with n a six month period or work Is suspended or abandoned for six months. I herebycertifythatIhavereadthisapplicationandknowthesametobetrueandcorrectAl!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 orlocallawregulationconstructionortheperformanceofconstruction_
1OwnerName: Ile. N i G 1 Phone Number: C qd ' G 10- 6"11
Mechanical Company: OCEAN STATE HEATING&AIR Office Phone: (904)249-8251 FaX(904)249$949
Co.Address: 1478 ATLANTIC BLVD. City: NEPTUNE BEACH FLState: Zip: 32266
license Holden J, GLENN JONES State Cimif+cation/Registration it CAC049310
Notarized Signature of License Holder
The foregoing strum,nt was acknowledged be re e this ay of l 20 Z? i the State of Florida,
County of Du
tkPublic v Yy p MORA!FS
e:\ Notary Public-State of Florida
Cemmissior. u-1 097967ersonaliyKnownORfIPucedIdentistionP,d° My coTr.:..,:ire:Mar 2.2025
Type of Identification; Boncoc throosih ranona.rotary assn,
77E d3o7J/t8 —
Eligible for Federal Tax Credit
i .. l CERTIFIED`,
www.ahridirectory.org
Certificate of Product Ratings
AHRI Certified Reference Number:9156554 Date:06-23-2022 Model Status:Active
AHRI Type:HRCU-A-CB(Split System: Heat Pump with Remote Outdoor Unit-Air-Source)
Series:PERFORMANCE 16 HP 2-STAGE
Outdoor Unit Brand Name:CARRIER
Outdoor Unit Model Number (Condenser or Single Package):25HCB648A'031'
Indoor Unit Model Number(Evaporator and/or Air Handler): FV4CN(B,F)005L
The manufacturer of this CARRIER product is responsible for the rating of this system combination.
Rated as follows in accordance with the latest edition of AHRI 210/240-2017 with Addendum 1,Performance Rating of Unitary Air-Conditioning&
Air-Source Heat Pump Equipment and subject to rating accuracy by AHRI-sponsored.independent,third party testing:
Cooling Capacity(A2)-Single or High Stage(95F),btuh:47000
SEER: 16.00
EER(A2)-Single or High Stage(95F): 12.50
Heating Capacity(H12)-Single or High Stage(47F):46500
HSPF(Region IV):9.00
f'Active'Model Status are those that an AHRI Certification Program Participant is currently producing AND selling or offering for sale;OR new models that are
being marketed but are not yet being produced."Production Stopped"Model Status are those that an AHRI Certification Program Participant is no longer producing
BUT is still selling or offering for sale.
Ratings that are accompanied by WAS indicate an involuntary re-rate. The new published rating is shown along with the previous(i.e.WAS)rating.
DISCLAIMER
AHRI does not endorse the product(s)listed on this Certificate and makes no representations,warranties or guarantees as to,and assumes no responsibility for,
the product(s)listed on this Certificate.AHRI expressly disclaims all liability for damages of any kind arising out of the use or performance of the product(s),or the
unauthorized alteration of data listed on this Certificate.Certified ratings are valid only for models and configurations listed In the
directory at rectory.ii
TERMS AND
CONDITIONSThisCertificateanditscontentsareproprietaryproductsofAHRI.This Certificate shall only be used for individual,personal and
confidential reference purposes.The contents of this Certificate may not,in whole or in part,be reproduced;copied;disseminated;
entered into a computer database;or otherwise utilized,in any form or manner or by any means,except for the user's individual,
personal and confidential reference. AIR-CONDITIONING,HEATING,
CERTIFICATE VERIFICATION REFRIGERATION INSTITUTE
The information for the model cited on this certificate can be verified at www.ahrldirectory.org,click on"Verify Certlficate"linkMit make life better"'
and enter the AHRI Certified Reference Number and the date on which the certificate was Issued,
which is listed above,and the Certificate No.,which is listed at bottom right.
2022Air-Conditioning, Heating, and Refrigeration Institute CERTIFICATE NO.: 133004704960832681