1342 Violet Street ACRS24-0055 Application
Updated 10/9/18
Mechanical Permit Application **ALL INFORMATION
HIGHLIGHTED IN
GRAY IS REQUIRED. City of Atlantic Beach Building Department
800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT #: _____________________
JOB ADDRESS: ______________________________________________ PROJECT VALUE $_____________________
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 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: ____________________ _______ Phone Number:
Mechanical Company: Office Phone: _________________ Fax
Co. Address: City: State: Zip:
License Holder: _______ ___ State Certification/Registration #
Notarized Signature of License Holder
The foregoing instrument was acknowledged before me this _____day of ___________, 20___, in the State of Florida,
County of _________________
Signature of Notary Public __________________________________________________
[ ] Personally Known OR [ ] Produced Identification
Type of Identification: _____________________________________________________
Duval