Permit 1912 Hickory Lane CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 10-00000517 Date 4/28/10
Property Address . . . . . . 1912 HICKORY LN
Application type description MECHANICAL HVAC ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
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Application desc
2 CU 2 AHU
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Owner Contractor
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WALLACE, LAYNE OCEAN STATE HEAT & AIR, INC.
1912 HICKORY LANE 1476 ATLANTIC BLVD.
ATLANTIC BEACH FL 32233 NEPTUNE BEACH FL 32266
(904) 249-8251
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Permit . . . . . . MECHANICAL HVAC PERMIT
Additional desc . .
Permit Fee . . . . 135 . 00 Plan Check Fee . 00
Issue Date Valuation . . . . 0
Expiration Date . . 10/25/10
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Fee summary Charged Paid Credited Due
--------- ---------- ---------- ---------- ----------
Permit Fee Total 135 . 00 135 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Grand Total 135 . 00 135 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
NOTICE OF COMMENCEMENT
(PREPARE IN DUPLICATE)
Permit No. Tax Folio No.
State of County of
Q To whom it may concern:
D � The undersigned hereby informs you that improvements will be made to certain real property,and in
W p accordance with Section 713 of the Florida Statutes,the following information is stated in this NOTICE OF
l COMMENCEMENT.
¢ Legal description of property being improved: _5 7� c f -zj;
n
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J o Y oo Address of property being improved:
s. J 3-trx-1 Ale- 13 :�e �z 3 1.2 33 r!3'7 1
N�U fF3 f
Q r z General description of improvements: 1� ���. `{�, e" f ..,..- r ✓T
Ac-
0
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tt� Z
o E Z5 o�g O w Owner l -z�s-z
0z W U tr Address [F,` P <<3:s
Owner's interest in site of the improvement
Fee Simple Titleholder(if other than owner)
f l Name
Address
_ 'Lr Contractor
iz Address_ 1 q 7( 4 f-t L,. i r A 1 LJ- r'q c,4 V.,t Z to
Phone No. -1Fax No.
Surety(if any)
Address Amount of bond S
Phone No. Fax No.
Name and address of any person making a loan for the construction of the improvements.
Name
Address
Phone No. Fax No.
Name of person within the State of Florida,other than himself,designated by owner upon whom notices or other
documents may be served:
Name
Address
Phone No. Fax No.
In addition to himself,owner designates the following person to receive a copy of the Lienor's Notice as provided in
Section 713.06(2)(b),Florida Statutes.(Fill in at Owner's option).
Name
Address
Phone No. Fax No.
Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a
Ltt date is s ledl:
THIS SPACE FOR RECORDER'S USE ONLY t OWN)r
Signed:li t.;f i �{�Ery F#�
Before ma this 14 e 0 tri the i
County of Duval,S e of Fl rids,has Re nay a Reared
r herein by I`\%J
himse8/herself and affirms that all statements and declarations herein
are true and accurate
nullunN/�iq�UOpU���t/gtlN���Op /�
YVETtE P.MORALES (('
* w 3FA2M 3 Notary Pu is at Large,State of County of
My comm expires:
�� F4it�lltAMI.MIC Peso Known or
M�aa�nNwer Produced Idenffiication
2
MECHANICAL PERMIT APPLICATION �J6\
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904)247-5826 Fax (904) 247-5845
JOB ADDRESS: I �r/2- 14 i,ropg4 j[a tA4 PERMLT#
PROJECT VALUE S 000. 0 0
NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity Tons Per Unit
Heat: Unit Quantity BTU's Per Unit Seer Rating
Duct Systems: Total CFM REQUIRED
REPLACEMENT AIR CONDITIONING cC HEATING SYSTEM INSTALLATION
ARI# 3(0 71277 3078'18
Air Conditioning: Unit Quantity 2 Tons Per Unit , f- 3 REOUIRED
Heat: Unit Quantity I— BTU's Per Unit S 's Ku.-, Seer Rating /S_z `4 t S
Duct Systems: Total CFM REQUIRED
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 BTU's
Elevators/Escalators
ALL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets Pumps
#Vented Wall Furnaces Refrigerator Condenser BTU's
#Water Heaters Solar Collection Systems
Tanks (gallons)
Wells
OTHER: 2 L,,� o
e
Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months.I here y ce-rtay1nuTltdve-tead
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.
Property Owners Name Fnvr',�- C-<,fit-cc- Phone Number Z'(S - /Y,37
Mechanical Company(I)Cf � Z,4-,
Office Phone z Yi9-2,zs-i Fax z V:-.,5 y r
Co. Address: 4 7(, i . Ae- City State fl- Zip
License Holder(Print): &it, e Certification/Registration# C,4G e'y 931 cZ)
Notarized Signature of License Holder
....... P�rMQ67J#LE&name worn:z-otf- taj
forte me s day of to 20P
Comm#C1DG860534
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% . a Florida NL4ary Assn.,Inc
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