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Permit Bldg Addition 300 5th St 2010 ,rte 11 ,x , 4 j CITY OF ATLANTIC BEACH � � 800 SEMINOLE ROAD �`�` "''` - ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5826 \ ''4 Jili9' 1 ' Application Number 10- 00001231 Date 10/27/10 Property Address 450 EAST COAST DR Application type description RESIDENTIAL ADDITION Property Zoning TO BE UPDATED Application valuation . . . 195000 Application desc addition Owner Contractor TOLBERT GENESIS BUILDING CORP 450 EAST COAST DRIVE 2158 MAYPORT RD. ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233 (904) 241 -0320 Structure Information 000 000 Construction Type TYPE 5 -B Occupancy Type RESIDENTIAL Flood Zone ZONE X Permit MECHANICAL HVAC PERMIT Additional desc . REPLACE 2 SYSTEMS 3 AND 3.5 TO Sub Contractor . HAMMOND AIR CONDITIONING INC Permit Fee . . . 191.00 Plan Check Fee . . .00 Issue Date . . . Valuation . . . . 0 Expiration Date . 4/25/11 Special Notes and Comments *2007 FLORIDA BUILDING CODE W/2009 REVISIONS NATIONALELECTRIC CODE *SUBMIT "CERTIFICATE OF COMPLIANCE" BY A LICENSED PEST CONTROL COMPANY PRIOR TO C.O. *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. Avoid damage to underground water /sewer utilities. Verify vertical and horizontal location of utilities. Hand dig if necessary. If field coordination is needed, call 247 -5834. Ensure all meter boxes, sewer cleanouts and valve covers are set to grade and visible. A reduced pressure zone backflow preventer must be installed if irrigation will be provided or if there is a private well on the property. Backflow preventer must be tested by a certified tester and a copy of the results sent to Public Utilities. Roll off container company must be on City approved list and container cannot be placed on City right -of -way. PERMIT IF APPROVED ACCORDANCE - WITH ACC CITY TI ' AITAN I'IC AND THE FL BUILDINO3rObItir Fees STATE MECH DCA SURCHARGE 2.87 ' � 1 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5826 P • Page 2 Application Number 10- 00001231 Date 10/27/10 Other Fees STATE MECH DBPR SURCHARGE 2.87 Fee summary Charged Paid Credited Due Permit Fee Total 191.00 191.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 5.74 5.74 .00 .00 Grand Total 196.74 196.74 .00 .00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. 771 7,7 HAMMOND hFAT INQ & AIR CONE: ` Hammond Air Conditioning, Inc 3412 GALILEE ROAD JACKSONVILLE, FL 32207 Phone # 904 - 398 -6488 Fax # 904 -398 -6055 www.hammondair.com Tthammond anair.com FAX TRANSMITTAL FORM To: Atlantic Beach, Permit Department From: Tammy Hammond Name: Date Sent: 10/27/10 Phone: 904- 247 -5826 Number of Pages: 1 plus cover Fax: 904 - 247 -5845 Message: Please find the attached mechanical permit application for 450 East Coast Drive, Atlantic Beach, FL 32233 Please call me when you receive this and I can give you a credit card payment. If you need any further information please do not hesitate to contact me, Th nk you - 4 T mond MECHANICAL PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach, FL 32233 - 115 Ph (904) 247-5826 Fax (904) 247 -5845 JOB ADDRESS: 'KO &5t ()O f -Ty t k ` t PERMIT # n - C- ElRf , ('l , F- 3 2 23 3 , o PROJECT VALUE S % S 000 r l, S0U° ec-c d i) 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 & HEATING SYSTEM INSTALLATION Air Conditioning: Unit Quantity c' Tons Per Unit 3 -Mn `" 3. -ton ARl # R EQ IR1� b 1 3 Heat: Unit Quantity _, BTU's Per Unit / Ob r d- Seer Rating for Bo's it Duct Systems: Total CFM (4200 W t¢o SOCK REQUIRE E Sy s ` 1, 4-00 FIRE PREVENTION Fire Sprinkler System Quantity (Requires 3 sets of plans) Fire Standpipe Quanti ty (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 Soar Collection Systems Tanks (gallons) Wells OTH'L: I � e plat nn � x , I i s�(s te�-,s ,,a; � + ) 'S�i,r, c►„r\� Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months. Y hereby certify that r have read this application and know the same to be true and correct. All provisions of laws and ordinances goveming this work will be complied with whether specified ]r 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 L y n 1 >~ T D 1 ber t J 3 r.- to.,+�r . ' C" S Phone Number ' gddl - 6 3 Ze koline-3q18-'41-1451CFax3•9'5-6 Mechanical Company �t r t�munc{ \Q ee (,4-0,,;1 T'nr, Office 05- Co. Address: 3 4{•i a ' l i `e e ' pc Cit D State FL Zip 2-20 -7 License Holder (Print): YC .yv4O'1 OA `YIrYiOnd State Certification/Registration ##C4C./'5J loq 6 Notarized Signature of License Holder ___ Sworn and subscribed before me this _ day of Z0 Signature of Notary Public �AC /� 13 -D l QC-e i - I�if e for jab of ENERGY PERFORMANCE LEA j c � SOe °S. DISPLAY CARD 605c a Hon" S ESTIMATED ENERGY PERFORMANCE SCORE The higher the score, the more efficient the home. / /"2' /G 1. New Home or addition Addn 11. Ducts, Location & Insulation Level 2. Single family or multiple family SF a. Supply ducts: Attic R =6 3. Number of units, (if multi- family b. Return ducts: At tic R= 6 4. Number of bedrooms 1 12. Cooling systems Capacity: 1.1 5. Is this a worst case? (yes or no) no a. Split system SEER: 6. Conditioned floor area 1. 7,49 sq. ft. b. Single package SEER: 7. Glass type & area c. Ground /water source COP: a. U- Factor: • 65 sq. ft. d. Room unit EER: (Or single or double Default) sq. ft. e. PTAC EER: b. SHGC: 3 S sq. ft. f. Gas - driven COP: (Or clear or tint Default) sq. ft. 13. Heating Systems Capacity: 1.1 8. Floor types, Insulation level a. Split system heat pump HSPF: a. Slab -on- grade, edge insulation R= 0 b. Single package heat pump HSPF: b. Wood, raised R= c. Electric resistance COP: c. Concrete, raised R= d. Gas furnace, natural gas AFUE: 9. Wall types, Insulation level e. Gas furnace, LPG AFUE: Exterior f. Gas - driven heat pump Recov. EFF.: a. Wood frame R= 13 14. Water heating systems b. Metal frame R= a. Electric resistance EF: c. Concrete block R= b. Gas fired, natural gas EF: d. Log R= c. Gas fired, LPG EF: e. Other R= d. Solar System with tank EF: Adjacent e. Dedicated heat pump with tank EF: a. Wood frame R= f. Heat recovery unit HeatRec% b. Metal frame R= g. Other: c. Concrete block R= 15. HVAC credits claimed d. Log R= a. Ceiling fans e. Other R= b. Cross ventilation 10. Ceiling types, Insulation level c. Whole house fan a. Under attic R= 30 d. Multizone cooling credit b. Single assembly R= e. Multizone heating credit c. Knee walls /skylight walls R= f. Programmable thermostat d. Radiant barrier installed R= I certify that this home has complied with the Florida Energy Efficiency Code For Building energy saving features which will be installed (or exceeded) in this home before final inspection. Otherwise, a new EPL Display Card will be completed based on Code compliant features. Builder Signature: Bosco Homes Date: 1 / 2 ' - /O Address of New Home: 318 5th Street City/FL Zip Atlantic Beach, FL 32233 *NOTE: The home's estimated energy performance score is available through the FLARES computer program. This is not a Building Energy Rating. Ifyour score is 80 or greater (or 86 for a US EPA/DOA Energy Star" designation), your home may qualify for energy efficiency mortgage (EEM) incentives if you obtain a Florida Energy Gauge Rating. Contact the Energy Gauge Hotline at 321/638 -1492 or see the Energy Gauge web site at www.fsec. ucf. edu for infor- mation and a list of certified Raters. For information about Florida's Energy Efficiency Code For Building Construction, contact the Department of Com- munity Affairs at 850/487 -1824. 13 -D.40 FLORIDA BUILDING CODE — BUILDING Effective March 1, 2009 FLORIDA ENERGY EFFICIENCY CODE FOR BUILDING CONSTRUCTION FORM 1100B -08 Residential Component Prescriptive Method B ALL CLIMATE ZONES Compliance with Method B of Chapter 11 of the Florida Building Code, Residential, or Subchapter 13 -6 of the Florida Building Code, Building, may be demonstrated by the use of Form 11008 for single -and multiple - family residences of three stories or less in height, additions to existing residential buildings, renovations to existing residential buildings, new heating, cooling, and water heating systems in existing buildings, and site -added components of manufactured homes and manufactured buildings.To comply, a building must meet or exceed all of the energy efficiency requirements on Table 11 B -1 and all applicable mandatory requirements summarized in Table 11 B -2 of this form. If a building does not comply with this method, it may still comply under Method A of Chapter 11 orSubchapter 13 -6 of the applicable code. PROJECT NAME: Lynley Talbert Design _ _ BUILDER: Bosco Homes AND ADDRESS: 318 5th Street PERMITTING - -- - Duval Atlantic Beach 32233 OFFICE: OWNER: Lynley Talbert Design PERMIT NO 1 1 L -_ 7 JURISDICTION NO 2 1 6 1 11 0 01 1. New construction including additions which incorporate any of the following features cannot comply using this method: skylights or othernonvertical roof glass, glass areas in excess of 16 percent of conditioned floor area, and electric resistance heat (See Notes to Table 11B-1 on page 2). 2. Fill in all the applicable spaces of the "To Be Installed" column on "Table 11 6 -1 with the information requested. All "To Be Installed" values must be equal to or more efficient than the required levels. 3. Complete page 1 based on the 'To Be Installed" column information. 4. Read "Minimum Requirements for All Packages ", Table 11 6 -2 and check each box to indicate your intent to comply with all applicable items. 5. Read, sign and date the "Prepared By" certification statement at the bottom of page 1. The owner or owners agent must also sign and date the form. Please Print CK 1. New construction, addition, or existing building 1. Addn 2. Single- family detached or multiple - family attached 2. SF 3. If multiple- family -No. of units covered by this submission 3. N/A 4. Is this a worst case? (yes/no) 4. No 5. Conditioned floor area (sq. ft.) 5. 1,249 6. Glass type and area: a. U- factor 6a. .65 b. SHGC 6b. .35 c. Glass area 6c. 60 _ sq. ft. 7. Percentage of glass to floor area 7. 5 % 8. Floor type, area or perimeter, and insulation: a. Slab -on -grade (R- value) 8a. R= 0 108 lin.ft. b. Wood, raised (R- value) 8b. R = sq. ft. c. Wood, common (R- value) 8c. R = sq. ft. d. Concrete, raised (R- value) 8d. R = sq. ft. e. Concrete, common (R- value) 8e. R = sq.ft. 9. Wall type, area and insulation: a. Exterior: 1. Masonry (Insulation R- value) 9a -1. R = sq. ft. 2. Wood frame (Insulation R- value) 9a -2. R = 13 1,540 sq. ft. b. Adjacent: 1. Masonry (Insulation R- value) 9b -1. R = sq. ft. 2. Wood frame (Insulation R- value) 9b -2. R = sq.ft. 10. Ceiling type, area and insulation: a. Under attic (Insulation R- value) 10a. R = 30 sq.ft. 927 b. Single assembly (Insulation R- value) 10b. R= sq. ft. 11. Air distribution system: Duct insulation, location 11a. R= 6 Attic Test report required if duct in unconditioned space 11 b.Test report attached? Yit5 No 12. Cooling system: 12a. Type: Central 12b. SEER/EER: 13 (Types: central, room unit, package terminal A.C., gas, none) 12c. Capacity: 1.1 13. Heating system: 13a. Type: HP (Types: heat pump, elec. strip, nat. gas, LP -Gas, gas h.p., room or PTAC, none) 13b. HSPF /COP /AFUE: 7.7 13c. Capacity: 1.1 14. Programmable thermostat installed on HVAC systems: 14. 1('s No 15. Hot water system: 15a. Type: N/A (Types: elec., nat. gas, LP -gas, solar, heat rec., ded. heat pump, other, none) 15b. EF: I hereby certify that the pia an pe ifications . • e ' a i la .. r ,r 1 • pliance ith Review of plans and specifications covered by this calculation indicates compliance with the Florida the Florida Energy Code. ,{/ / / Energy Code. Before construction is completed, this building will be inspected for compliance in vvv accordance with Section 553.908, F.S. PREPARED BY: Gary L. Wallo DATE: 1011512010 _4 BUILDING OFFICIAL: I I hereby certify that this building is in compliance with the Florida Energy Code: OWNER AGENT: DATE: DATE: 11 _ 2007 FLORIDA BUILDING CODE - BUILDING 13 -D.23 IA CITY OF ATLA NTIC BEACH �� , � =" 800 SEMINOLE ROAD ") ATLANTIC BEACH, FL 32233 JF1 INSPECTION PHONE LINE 247 -5826 Application Number Property Address . . . • • 10- 0 0001231 Application type 450 EAST COAST DR Date 11/01/10 Application ype description RESIDENTIAL Property Zoning ADDITION - - -_ Application valuation , TO BE UPDATED -- - - - - -- 195000 Application desc ----- _addition - ------------- - - - - -- ------------------------- ---------------------------- Owner --------------------------------------- _ Contractor TOLBERT _ GENESIS BUILDING CORP 450 EAST COAST DRIVE ATLANTIC BEACH 2158 MAYPORT RD. - - - - -- FL 32233 ATLANTIC BEACH -- Structure Information 9 000 000 -0320 FL 32233 Construction Typ Occupancy Typ TYPE 5 -B - ----- ------- - -- --- Flood Zone . . . • • • R --------------- - - - - -- ZONE X Permit -------------- - - - - -- _______ • Additional desc • • MECHANICAL HVAC PERMIT -------- • Sub Contractor REPLACE 2 SYSTEMS 3 AND 3.5 TO Permit Fee HAMMOND AIR CONDITIONING INC Issue Date 191.00 Plan Check Fee Expiration Date 10/27/10 Valuation .00 -------------- -- ------------------------------------------------------------ 4/25/11 0 Special Notes and Comments *2007 FLORIDA BUILDING CODE W /2009 REVISIONS NATIONALELECTRIC CODE *SUBMIT "CERTIFICATE OF COMPLIANCE CONTROL COMPANY PRIOR TO C.O. " BY A LICENSED PEST * REPORT ANY UNFORSEEN STRUCTURAL D DEPARTMENT IMMEDIATELY. DAMAGE TO THE BUILDING Avoid damage to underground water /sewer utilities. vertical and horizontal location of utilities. Verify necessary. If field coordination is needed, call a 24 7 - 5834 . Ensure all meter boxes, sewer cleanouts and valve cover are set to grade and visible. A reduced pressure zone backflow preventer must be covers installed if irrigation will be provided or if there is a ITivate well on the property. Backflow preventer must be tested by a certified tester and a copy of the results sent to Public Utilities. Roll off container company must be on City approved list and container cannot be placed on City right -of -way. PEa1s APPROPED ACCORDANCE % .*tI ERN -OF - ATbANTIC- -�,Aex OR INANc�s A i4 F �A VALDI 1 Fees STATE MECH DCA SUR 2.87 ItNI . r r r = � CITY OF ATLANTIC C BEACg , 800 SEMINOLE ROAD x,31 } INSPECTION PHONE ATLANTIC BEACH, FL �� � � r HONE 32233 2 47 -5826 - -_ -- Application Number - - -___ 10- 00001231 Page 2 - ________________________________________________________________ Fees -------------------- - - - --- _ Date - - - - -- 11 /01/10 _ _ STATE -- - -- -- -- __ DBPR SURCHARGE Fee - summary - - - -- - Charged -- - -____ - -- _ ged Paid ------- - - - --- Permit Fee Total - - - -- Credited - - - - --- Plan Check Total 191.00 -__ -- ---- __ -___ _ -- Due Other Fee Total .00 191.00 -- - - - -- .00 .00 .00 Grand Total 5.74 5.74 . .00 ▪ 00 196.74 196.74 .00 .00 • 00 . 00 MECHANICAL PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach, FL 32233 Ph (904) 247 -5826 Fax (904) 247 -5845 /r - /23 J JOB ADDRESS: 4 G! ft oat (''v--e--- PERMIT # A4- Wail , Fl- 3 223 . c, PROJECT VALUE t 3 ✓ 00(? rl, SoO �. e _c'c h j 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 & HEATING SYSTEM INSTALLATION , 3 -rnr, . / 4443444 e ARI # i IU(n3i I /4443444e Air Conditioning: Unit Quantity c Tons Per Unit � "Tor) REQUIRED Heat: Unit Quantity r,2 BTU's Per Unit 3 4 ■ d- Seer Rating I 6 10 r 8001 k t7 Duct Systems: Total CFM t 200 �- q C°° REQUIRED 5Y s ` l, CC 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) -� i n Wells OTH • r- )-�• e lo-c. . e x . t , 4'-1 r t'M 5 5 S �'1 c4 '` 1 �t _, (A tl . r\ c4 i 3 . +`C, w--. 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. Property Owners Name L \J rl I �_�,.. T beg- t / c ` � © � �S C � Phone Number "' 41- 6 3 Zv Mechanical Company 42tr tykunci t�t\Q ec,„,, O',, ` , ' .T-nL Office P o c � - ax 39 g 05 � - � G ol. I a . Co. Address: ' t e UG,r� City State Zip License Holder (Print): �C� c� A 01\ 0 i� ifY1 rv'�G +rte'• State Certification/Registration #(' f k_I . 1 tc 1 O ,.... Notarized Signature of License Holder Sworn and subscribed befor- ;semis' ' - ,ll1. i t/ 20 fa Signature of Notary Public I a r�= p ' Y c� S T �o 957760 A ) / ,„ , , , . onded Th otary Public Undue ld?Q _ 4 4. { I CITY OF ATLANTIC BEACH ' ' (7) 800 SEMINOLE ROAD ATLANTIC BEACH, FL f' N INSPECTION PHONE LINE 247 -5826 32233 3111 Application Number 10- 00001231 Property Address 3 Date 11/16/10 300 5TH ST Application type description RESIDENTIAL ADDITION Property Zoning TO BE UPDATED Application valuation . . . 195000 Application desc addition Owner Contractor GENESIS BUILDING CORP 2158 MAYPORT RD. ATLANTIC BEACH FL 32233 (904) 241 -0320 Structure Information 000 000 Construction Type TYPE 5 -B Occupancy Type RESIDENTIAL Flood Zone ZONE X Permit MECHANICAL GAS PIPE PERMIT Additional desc . 120 GAL TANK, WHEATER, STOVE Sub Contractor . FLORIDA PROPANE PARTNERS Sub Contractor . LORE ELECTRICAL CONTRACTORS Permit Fee . . . 95.00 Plan Check Fee Issue Date 00 Expiration Date . . 5/15/11 Valuation 0 Special Notes and Comments CHANGED FROM 450 EAST COAST DR 11.2.10 qq.00 *2007 FLORIDA BUILDING CODE W/2009 REVISIONS NATIONALELECTRIC CODE *SUBMIT "CERTIFICATE OF COMPLIANCE" BY A LICENSED PEST CONTROL COMPANY PRIOR TO C.O. *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. Avoid damage to underground water /sewer utilities. Verify vertical and horizontal location of utilities. Hand dig if necessary. If field coordination is needed, call 247 -5834. Ensure all meter boxes, sewer cleanouts and valve covers are set to grade and visible. A reduced pressure zone backflow preventer must be installed if irrigation will be provided or if there is a private well on the property. Backflow preventer must be tested by a certified tester and a copy of the results sent }} fiR Public NLY p Utilities. }� r�� PERMIT IS A1�VE6 I ET( C ( WilgYL H )F"A 7(r 74(H 431111PINRIVAS A IJ g4E FLORIDA BUILDING CODES. w - j!.-t1P1r , .r 1�, ,4,,, S CITY OF ATLANTIC BEACH .. _ 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5826 J111.9"' Application Number Page 2 10- 00001231 Date 11/16/10 Special Notes and Comments and container cannot be placed on City right -of -way. Fee summary Charged Paid Credited Due Permit Fee Total 95.00 95.00 Plan Check Total . .00 .00 .00 .00 .00 Grand Total 95.00 95.00 .00 .00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. MECHANICAL PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach, FL 32233 Ph 904) 247 -5826 Fax (904) 247 -5845 JOB ADDRESS: J ST, PERMIT #/ 0 — 1Q\ 3 1 PROJECT VALUE $ 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 & HEATING SYSTEM INSTALLATION Unit Quantity ARI # Air Conditioning: Q y Tons Per Unit REQUIRED Heat: Unit Quantity BTU's Per Unit Seer Rating 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 ALL OTHER GAS PIPING 6,11_,,-( Hlevators /Escalators Quantity of Outlets Heat Exchanger # Vented Wall Furnaces ( Pumps # Water Heaters Refrigerator Condenser BTU's Solar Collection Systems Tanks (gallons) ii Wells OTHER: 0 0 2© I 1�,� B S I A i 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. Property Owners Name Phone Number r__.. Mechanical Company th, 11 "+ I S�-O e J�C} � r 1 Q , liJ ffice Phon tf Fax7al a '73 Co. Address: 4 - / eR'R,s c --R( City Stat ��� F f Zip - License Holder (Print): r, t `° 1 ■ ∎ e k % L : _• State : ification/Registration # S • r Notarized Signature of License Hob ' r �, -.1'l/' Sworn and subscribe, before 7 this 1 day of 20 <.n�'Pt, DEBORAH A. WHITE - ■ ''.A.? :Y MY COMMISSION a DD 634126 • ignature of Notary Public C t- t -. . .. 9 aMed X Thruu Notary Pu