2279 Seminole Road Unit 6 GSRS24-0039 Mechanical Gas dilL
�S` MECHANICAL RESIDENTIAL GASPERMIT NUMBERJ ' t�
PERMIT GSRS24-0039
5 ISSUED: 4/22/2024�. o111 v CITY OF ATLANTIC BEACH EXPIRES: 10/19/2024
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.
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:
2279 SEMINOLE RD UNIT 6 MECHANICAL RESIDENTIAL GAS GAS PIPING - ONE FIXTURE $1970.00
TYPE OF REAL ESTATE BUILDING USE
I ZONING: SUBDIVISION:
CONSTRUCTION: NUMBER: I GROUP:
168345 0050 SECTION LAND
COMPANY: ADDRESS: CITY: STATE: ZIP:
PERFORMANCE GAS
SYSTEMS LLC 14705 EDWARDS CREEK RD JACKSONVILLE FL 32226
OWNER: ADDRESS: CITY: STATE: ZIP:
OYAMA OLIVER 30 KREAMER AVE TARPON SPRINGS FL 34689
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 CONDITIONS
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 1 $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:4/22/2024 1 of 2
Mechanical Permit Application **ALL INFORMATION
`� HIGHUGHTED IN
:,41-1°'fi
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Road, Atlantic Beach, FL 32233e 7d Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT 41: C SRsZ4-b `)
JOB ADDRESS: 2279 Seminole Rd PROJECT VALUE$1970.00
El NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI#(REQUIRED)
❑ Air Handling Equipment Only 0 Condenser Only 0 Air Handling Unit& Condenser
Air Conditioning: Unit Quantity Tons per Unit
Heat: Unit Quantity BTUs per Unit Seer Rating(REQUIRED)
Duct Systems: Total CFM
7 REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI#(REQUIRED)
0 Air Handling Equipment Only 0 Condenser Only 0 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 1 set of digital plans)
Fire Standpipe Quantity (Requires 1 set of digital plans)
Underground Fire Main Value (Requires 1 set of digital plans)
Fire Hose Cabinets Quantity (Requires 1 set of digital plans)
Commercial Hoods Quantity (Requires 1 set of digital plans)
Fire Suppression Systems Quantity (Requires 1 set of digital plans)
❑FIRE PLACES Ei MISCELLANEOUS:
Prefabricated Fireplace(Qty) Automobile Lifts
Gas Piping Outlets Boilers BTUs
Elevators/Escalators
MALL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets 1 Pumps
#Vented Wall Furnaces Refrigerator Condenser BTUs
#Water Heaters Solar Collection Systems
Tanks (gallons)
Wells
DOTHER: Installing gas piping from LP tank to new gas cooktop
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: jeFf /L4r7 Phone Number: *9-SZ9'5-69,
Mechanical Company: Performance Gas Systems,LLC Office Phone: 904-509-5099 Fax
Co.Address: 14705 Edwards Creek Rd City: State: Zip:
License Holder: Jew /4-r/Ls State Certific.tion/eg'str.tion# 15834
Notarized Signature of License Holder ,
The foregoing t strument s acknowle ge efore me thisZ day .f,-ao I iii 4 • the State of Florida,
County of 1, � 0 kfc.. — I
\\ Signature of Notary Public fid.
,,, p�., [ ] Personally Known OR [ ] Produced Identification
a°`-•' .1•-. TONI GINDLESPERGER Type of Identification: �. L___AI MY COMMISSION#HH 407122
%»Q' EXPIRES:October 6,2027 Updated 10/11/23
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