Permit Mech 523 Clippership Ln 2010 T � sz1 CI
-� Y OF ATLANTIC BEACH
'
800 SEMINOLE ROAD
ATLANTIC BEACH
4 4.7 .11=� ' F L 32233
INSPECTION PHONE LINE 247 -5826
Application Number
Property Address . . 10- 00001303
Date 10/26/10
Application type description � 523 CL IPPERSHIP LN
A pplication
Zoning MECHANICAL
- -- _Application v aluation . . ' ' TO BE UPDATED
ONLY
TED
Application -------- ------- - - - --- 7800
n desc
-____- change out - 3_ ton - system --------------------------------- - - - ---
Owner-- _ - - - -_ --- ---- ------------ -- ------------------ - - - - -- _
HALSTEAD, JAMES Contractor
523 CLIPPERSHIP LANE - _____
ATLANTIC BEAC OCEAN STATE HEAT & AIR, INC.
FL 32233 1476 ATLANTIC
--- - - - - -- ____ -- NEPTUNE BEACH BLVD,
Permit ----- ______ (904) 249 -8251 FL 32266
Additional desc . . MECHANICAL HVAC PERMIT ___
Permit Fee CHANGE OUT 3 TON SYSTEM
9 9.00
Issue Date
_Expiration Date Plan Check Fee . ,
_ -- __ 4/24/11 Valuation 00
Other Fees
----------------------------------------- ----- 0
STATE MECH DCA SURCHARGE ------ -- -- - - - --
-- ________ STATE MECH DBPR SURCHARGE 2.00
Fee summary ----------- ---- - -- .00
Fee s ---_Y - - - - -_ Charged_ Paid ----------------------- ? - - -__
Permit Fee Total --- -_____ Credited Due
Plan Check Total 99.00 99.00 ---- -- - - --
Other Fee Total .00
.00 ' .00
Grand Total 4.00 4 .00
' 00 .00
• oo .00
103.00 103.00
. 00 .00
MECFIANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233 /0'13 b 3
Ph (904) 247 -5826 Fax (904) 247 -5845
JOB ADDRESS: .5 L (1,1 1 l t,. L-- PERMIT #
PROJECT VALUE 7 200. 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 & HEATING SYSTEM INSTALLATION
ART # 3 V 9571 0
Air Conditioning: Unit Quantity 1 Tons Per Unit 3 REQUIRED
Heat: Unit Quantity / BTU's Per Unit /0 Ka) Seer Rating / Co
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'
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:
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 NOrr a.i, /t,'n wvl Phone Number a Y F - z,-z a
Mechanical Company 00-_-e-/ c._ 1- ; v■ , d . T Office Phone Z �i t -2 r Fax Z Y9 - 2 5 y ?
Co. Address: I 7(D .. 44-in :Q--c1 6 luJ City ltyM :ir, g.,..,2-c.i-N State FL Zip 3 z 2.6t,
License Holder (Print): . G--! ,., v r N _ • a e Certification/Registration # �A y e q.? /z)
Notarized Signature of License Holder i►a>i/ 7
ES `worn an: , - = fore me this -'G day of r b' 20I(
5 for..a ip» „�, Oomm# DD086053 'r tune of ■ start' Public `/ U-1 � '
-- 1 E xp i re s 3 !2/2013 �.�
I Florida Notary ss
An., ble
'Yif � � oa .
NOTICE OF COMMENCEMENT
!PREPARE IN DUPLICATE
Permi: No. Tax Folio Nc.
State of / . L. County of
To whom It may concern:
The undersigned hereby informs you that improvements will be made to certain real property, and in
accordance with Section. 713 of the Florida Statutes, the following information is stated in this NOTICE OF
COMMENCEMENT.
Legal description of property Deing improved: ;,3 ._ ` i / 7 -
Address of property being improved: F 2-
2-2_1 '
Genera' description of improvements:
Owner Nixfwu
Address • 1 3 C 1,tyr v�,? t t� 11(14...,1k rt_ 3 LS 3
Owner's interest in site of the improvement
Fee Simple Titleholder (if other than owner)
• Name
Address
Contractor G c_: ; _ c � �`r - It< �� n «,
�;.� Address 117l, ft , 1f'r Arm : � /Yc tv, �c r,'_., TZ y 2z .4(4
Phone No. Qc•Y° 2 it S - z .S °1 Fax No, s [ "•/ 2 YS' -/5 Y
Surety (if any
Address Amount of bond E
°none Nc. Fax. Nc.
Name and address of any person making a loar 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. (Fit 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
different date is specified):
THIS SPACE FOR RECORDER'S USE ONLY i ,� !'W R / i• �/ f t�
Signed: \ ...d _.�L/) 4 L/ DATE
(
Before me this • .y of i 1rw in ‘he i
County of Duval, State o Florida, has personally a•peared
herein by
himself/ herself and affirms that all statements and declarations herein
are true and accurate
uoc # 20 102o0 zo. ilf< t3K 1 5409 rage i 43 YVETTE P. MORALES Number Pages: 1 I, .. 1 k , ► / / I r I\e. OAP nnnaan5'