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BUILDING AND ZONING INSPECTION DIVISION
CITY OF ATLANTIC BEACH
ATLANTIC BEACH, FLORIDA 32233
APPLICATION FOR MECHANICAL PERMIT CALL-IN NUMBER
IMPORTANT Applicant to complete all items in sections 1, 11, 111, and IV.
Street Address: zj�, &a'eyl at4'6e_
LOCATION
OF Intersecting Streets: Between qt�2�444' -&2M IeL And
BUILDING
Sub-division
11. IDENTIFICATION —To be completed by all applicants
In consideration of per mit 9 iven for doing the work as described in the abcve statemenf we hereby agree to perform said work in accordance
with the atfachLed plans and specifications which are a part hereof and in accordance with the City of Jacksonville ordinances and standards
of good,.practice listed therein.
Home of Mechanical Contractors
Contractor (Print 1 "91R 6�v&'Qezlza ':�2wnl Master
Nams, of I
Property Owner e�:Ilio 7—
Milk, of Owner Signsfure of
,mod Agent Architect or Engineer
GIENERAL INFORMATION
A, Type of heating fuel: B. IS OTHER CONSTRUCTION BEING DONE ON 3-
& Electric THIS BUILDING OR SITE?
El Gas—0 LP 0 Natural 0 Central Utility
IF YES. GIVE NUMBER OF CONSTRUCTION
E3 Oil PERMIT
0� Other — Specify
IV. MICKANIC.All. EqUIPMGNT TO BE INSTALLED NATURE OF WORK
(Provido complete list of components on back of this form) AL_ Residential or [I Commercial
h—Heat 0 Space Q Recessed &, Central C31 Flow 13 New Building
A!,Concirtio.mg: 13 Room Jk Control Or_gxisting Building
C) Duct System: Material Thickness— Replacement of existing system
moelmVIP11%capacity 13 New installation(No system previously installed)
0 Extension or add-on to existing t-istern
C) Cooling tower: Capacity Other — Specify
(3 Firit sprinklers: Number d heads
E] Elevator C] Monfift 0 Escalefor—i[numbeirl THIS SPAC* 111011. C*F= USE ONLY
CI Gasoline pumps —(number)
11 To 3numbed Remarks
13 LPG contain (number)
CI Uftfimd pressure vowel
0 Sellers Permit Approved Date.
d 00w — Specify Permit Fee
Uffr ALL EQUIPMENT
AM CONDMOMNG AND REFRIGERATION EQUIPMENT
ca ty A all
NUMberUnite Dewriptim X0"NUMbar Mmufacturer (TOM)