Permit 213 Beach Avenue BUILDING AND ZONING INSPECTION DIVISION
CITY OF ATLANTIC BEACH
ATLANTIC REACH, FLORIDA satin
APPLICATION FOR MECHANICAL PERMIT CALL•IN NUMBER
IMPORTANT -- Applicant to complete all items in sections I, II, III, and IV.
2 3 .firL,.
LOCATION Street Address:
OF Intersecting Streets: hlween And
WILDING
sai.divislo..
II. IDENTIFICATION -- To be completed by all applicants ,
1. conuder.s en of permit gi,en for doing the work a described in the above statement we hereby agree to perform said work in accordance
with the attached plans end specifications which are a part hereof and in accordance with the City of Jacksonville ordinances and standards
o f gocd precut• listed therein.
Mums of .fr .cte ' eel (Print) trea ►ors
C. t ) � t Mast.'
( /rio) Twk� Math►
N.M el r te' IBC
Mprty Owner ; 0".1M•
Sigssetrre of Owne r Ci1aR' of
A.Ihwisad Agent Architect er Engineer
111. GENERAL INFORMATION
A. typo o bating fuel; ES, 111 OTHER CONSTRUCTION BEING DONE ON
Fredric THIS WILDING OR SITE?
Q 6.. — ❑ U 0 News! (] Control Utility
IF VES, GIVE NUMBER OR CONSTRUCTION
❑ OD PERMIT
Q Othw — $.cfy
IV. IMMAMICAL EQUIPMENT TO EE INSTALLED NATURE OF WORK
(Provide cote*. Jilt of ce.speeonts ea boa of this form) X Residential or ❑ Commercial
Heat ❑ Spec* 0 Recesses Ceehel Q Roe. ❑ New Building
Aie Cenbtioniwg: O Room X Ceet el Existing euUding
Q D.ct Syst.w: 140.6.1E4 tri Replacement of existing system
Mosiwwss capacity
❑ New Installation (No system previously installed)
Q Ref.igewf+ee O Extension or add-on to existing system
❑ Other — Specify
Q Cooling "won Capacity
i Q
Pre "tinkle's: Nensber ei heath
Q Noyes. 0 Islanlift 0 Eseslohr (sns.bsr) nos !►ACE FOR OPPICE use ONLY
Q &noses camps (symbol (Reedvsd)
Q Task (nsn►ber) Retnseit
Q
U'S oeet. in.r.. (sstn,bsr)
Q U.fired p eNnre vessel
Pernik Approves by Deis
O Bohn
Q other — Specify Permit
LIST ALL EQUIPMENT
AIR CONDMONING AND REFRIGERATION CQUIti[ENT
Number Volta Deeeriptiea Mold Number lemmtactuter (raj %Z
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