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Permit 54 Simmons Rd 2011 SFAT
CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH FL 32233 C E R T I F I C A T E O F O C C U P A N C Y P E R M A N E N T Issue Date 4/09/12 Parcel Number 172174 -0000- - Property Address . . 54 SIMMONS RD ATLANTIC BEACH FL 32233 Subdivision Name . . . Legal Description . . . Property Zoning . . . TO BE UPDATED Owner BEACHES HABITAT FOR HUMANITY Contractor BEACHES HABITAT 904 241 -1222 Application number . . 11- 00002401 000 000 Description of Work . . SINGLE FAMILY ATTACHED DWELLING Construction type . . . TYPE 5 -A Occupancy type . . . RESIDENTIAL Flood Zone ZONE X Special conditions . 2007 FLORIDA BUILDING CODE WITH 2009 REVISIONS Approved / 1 , L k �r. Buildi Officiad ,.� VOID UNLESS SIGNED BY BUILDING OFFICIAL CITY OF ATLANTIC BEACH CERTIFIC ATE OF OCCUPANCY WORKSHEET Date Requested: �O / /'2-- Contractor Name: &Le Le 5 1 Permit #: //' V 1 Property Address: 57;19/17d/1 S PI Legal Description: Improvements to the above - described property have been completed in accordance with the ter s of the permit and are certified to be ready for occupancy as: Single - Family Residence Commercial ❑ Other: Lowest Floor Elevation: Required As Built FFE The following must be completed before issuing Certificate of Occupancy: Department Date Notified Date Approved Approved By Fire Dept. -- Public Works 1 4- PA) Public Utilities 6- //-c , / c.J Building , / 7 Planning Tree Mitigation / Satisfied Final Survey with FFE ' / Yes No All Re- Inspect Fees Paid / No Termite Treatment Yes No White, Debbie From: White, Debbie Sent: Thursday, April 05, 2012 2:49 PM To: Carper, Rick; Nodine, Phil; Kaluzniak, Donna; Walker, Chris; Clemons, Malcolm; Hall, Erika Cc: Graham Shirley; Jones, Mike Subject: CERTIFICATE OF OCCUPANCY REQUESTS TO ALL: Beaches Habitat has requested their Certificate of Occupancy inspections on: 12 -2400 52 Simmons Road 12 -2401 54 Simmons Road Please email me your results.. Thanks, Debbie Debbie White City of Atlantic Beach Building Department (904) 247 -5826 (904) 247 -5845 FAX 1 White, Debbie From: Nodine, Phil Sent: Friday, April 06, 2012 12:59 PM To: White, Debbie; Carper, Rick; Kaluzniak, Donna; Walker, Chris; Clemons, Malcolm; Hall, Erika Cc: Graham Shirley; Jones, Mike Subject: RE: CERTIFICATE OF OCCUPANCY REQUESTS Good to go for PW From: White, Debbie Sent: Thursday, April 05, 2012 2:49 PM To: Carper, Rick; Nodine, Phil; Kaluzniak, Donna; Walker, Chris; Clemons, Malcolm; Hall, Erika Cc: Graham Shirley; Jones, Mike Subject: CERTIFICATE OF OCCUPANCY REQUESTS TO ALL: Beaches Habitat has requested their Certificate of Occupancy inspections on: 12 -2400 52 Simmons Road 12 -2401 54 Simmons Road Please email me your results.. Thanks, Debbie Debbie White City of Atlantic Beach Building Department (904) 247 -5826 (904) 247 -5845 FAX 1 White, Debbie From: Clemons, Malcolm Sent: Friday, April 06, 2012 1:45 PM To: White, Debbie Subject: RE: CERTIFICATE OF OCCUPANCY REQUESTS Backflow inspection ok. Malcolm From: White, Debbie Sent: Thursday, April 05, 2012 2:49 PM To: Carper, Rick; Nodine, Phil; Kaluzniak, Donna; Walker, Chris; Clemons, Malcolm; Hall, Erika Cc: Graham Shirley; Jones, Mike Subject: CERTIFICATE OF OCCUPANCY REQUESTS TO ALL: Beaches Habitat has requested their Certificate of Occupancy inspections on: 12 -2400 52 Simmons Road 12 -2401 54 Simmons Road Please email me your results.. Thanks, Debbie Debbie White City of Atlantic Beach Building Department (904) 247 -5826 (904) 247 -5845 FAX 1 White, Debbie From: Walker, Chris Sent: Friday, April 06, 2012 9:05 AM To: White, Debbie Subject: 52/54 Simmons All good here. White, Debbie From: Hall, Erika Sent: Monday, April 09, 2012 9:16 AM To: White, Debbie Subject: RE: CERTIFICATE OF OCCUPANCY REQUESTS Tree Permit is closed / no mitigation due; No other known P/Z issues. Thanks, Erika From: White, Debbie Sent: Thursday, April 05, 2012 2:49 PM To: Carper, Rick; Nodine, Phil; Kaluzniak, Donna; Walker, Chris; Clemons, Malcolm; Hall, Erika Cc: Graham Shirley; Jones, Mike Subject: CERTIFICATE OF OCCUPANCY REQUESTS TO ALL: Beaches Habitat has requested their Certificate of Occupancy inspections on: 12 -2400 52 Simmons Road 12 -2401 54 Simmons Road Please email me your results.. Thanks, Debbie Debbie White City of Atlantic Beach Building Department (904) 247 -5826 (904) 247 -5845 FAX 1 to W W m m r to r r r E m r to r to r r H pr V O n b n ro -.1 0 0 r M to co W to P 0 r to CO CO to .1 I-' ro ro ›:X00 z H M N ■ OnWH�7ttI Kro�y o o 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 y C Y to 0 50 H N r N r r N H N r H r r r r H H H .. 0 to 'I M H 0 CA I tti. • . 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X ty ti hi 31 H H z M x M M bx M Za zCC3D £ 3D roUD 2 3D 0 H Zt 4 M 0 4 3D O • C N C tI M O HM 0 O o 0 G)i 0 'bz zz 3 W z [i1 M n N H x t" E x 0 H t" H r C H Z i O 0 tD M M 0 4 M 3D M H ro 'V m 4C n H roy7 P. 0 H H 0 0 3D M=0 W M t x ID W f) 3N H 0 CI H zL ol LID H 0 H K C < Z C Co 30 ■ 00 P N N P P H H H H N N W M N W el ro H 0 M M P ■ 0 m I- N M s a g t • • • ERVICENOIES?• )"..19 pre — C./4 - trea..1-,per-ft-- AMOUNT PAID Li CASH CLI HECK NO. ** .EikTED — LI CREDIT CARD TERMIDOR SC .06°k ATTIC DEMAND CS CRAWL -tiSTOMER SIGNATURE. n , n 4 4 • MAXFORCE GEL .01°k INTERIOR NIBAN .5°/0 EXTERIOR DELTA DUST .05% PERIMETER SUSPEND SC .06% EAVES OTHER GARAGE r i< ------- h - 2 vwleu the satist.ctor, mpletion of services OTHER ts6= renccreo •nd sorcc to pay the cost of services as specified OTHER abcm - 42113MalaSSERVICE-(7 ,7777 ESCRIPTIO _ _ .1300LONTINFORNIA1/010; PRECONSTRUCTION PRECONSTRUCTION $0.00 Bill-To: [103561] Subtotal $0.00 BEACHES HABITAT We are grateful for your business Tax $0.00 PAUL FINDLEY Total $0.00 54 SIMMONS ROAD Thank you, _ DAVID HONRA ATLANTIC BEACH, FL 32233 TH, OWNER Amount Due $0.00 904-334-2278 Order: 40084 Tech: 16 Date: 03/19/12 Day: Monday Time In: Time: 09:30 Tech: 2 Time Out: IC:0 Target Pest: Map: / Location: [103561] 904-334-2278 BEACHES HABITAT 2nd TREATMENT PAUL FINDLEY 54 SIMMONS ROAD ATLANTIC BEACH, FL 32233 3 hq u 0 t E .' 0 d h o P t V 1,4 I 4 4 0 7 li • 0 ID 0 q Y ti L. al E K @ m r id c ma x ° '., °W' Po o • d h b o b e w o p p + r 0 it V, o !II G C w li C) z ,'� "ill rFLi% E N o f N t1 �+ O o 1. G °' a y F Q O �s�, Vol N .. O y T t d CI' • ,- O \, A c o E ( CND a ` `) ti o a' W G+ w § = c � 8�� o Q C c os o ° o O R ea N x y 3 P a a a 0 en 03/12/2012 15:13 904 - 2490703 BROOKS AND LIMBUAGH PAGE 02/02 EARLY POWER AGREEMENT & RELEASE 0 CITY OF ATLANTIC BEACH Electric power is requested now under the conditions and terms of this fully executed Agreement & Release Job Address r �T yi ri$ K Permit No. 11- CSC_ -O 1 Service Type (Circle One): Overhead Underground We, the undersigned General Contractor and Electrician, understand and agree: 1. "Early Power" is purely for our construction convenience, it is not required by Codes and does not substitute for Final "inspections or the C/O (Certificate of Occupancyjffiat must be issued before occupancy, and as such is at the discretion of the Building Official. 2. The City of Atlantic Beach will make a special inspection prior to the early power energizing. All rough inspections must have prior Approval, including meter base connections. 3. Occupancy or use of the new construction before a formal C/O constitutes fraudulent use of the early electric service. Such action is expressly prohibited and penalized by The City of Atlantic Beach Ordinances. A violation of this Agreement shall result in a request for prompt removal of electric service after a twenty -four hour notice. 4. "Early Power" release authority is the Electrician and/or the Contractor and, must not occur before: a. Equi inent, devices and fixtures are installed (or blanked off) safely. b. Panel is complete with breakers and cover, and (labeling required at final inspection). c. Service connection and grounding is complete. d. The electric system has safely passed through electrical check. e. Meter can is permanently marked with address. f. Temporary address numbers displayed (Permanent numbers are required for C /O). 5. This fully completed form is to be submitted to the Building Department by hand, mail or fax. 6. Future such Agreements will not be accepted from those who violate any one of the above items. CONTRACTOR ;� Y DATE 43 ' J — PRINT NAME / 1 21 ELECTRICIAN � �, � � . �I m � DATE LA: i"�l G l PRINT NAME • • 800 Seminole Road, Atlantic Reach FL 32233 Phone: (904)247 -5826 Fax: (904)247 -5845 http: /Iwww.coab.us revised 01 30 09 �' r f CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD '� ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5814 A fa) 111 Application Number 11- 00002400 Date 9/01/11 Property Address 52 SIMMONS RD Application type description SINGLE FAMILY ATTACHED DWELLING Property Zoning TO BE UPDATED Application valuation . . . 75000 Application desc NEW SINGLE FAMILY ATTACHED Owner Contractor BEACHES HABITAT 1671 FRANCIS AVENUE ATLANTIC BEACH FL 32233 (904) 241 -1222 Structure Information 000 000 Construction Type TYPE 5 -A Occupancy Type RESIDENTIAL Flood Zone ZONE X Permit PLUMBING PERMIT Additional desc . Sub Contractor . ADVANTAGE PLUMBING Permit Fee . . . 125.00 Plan Check Fee . . .00 Issue Date . . . Valuation . . . . 0 Expiration Date . 2/28/12 Special Notes and Comments *2007 FLORIDA BUILDING CODE W/2009 REVISIONS NATIONA1 ELECTRIC CODE *SUBMIT "CERTIFICATE OF COMPLIANCE" BY A LICENSED PEST CONTROL COMPANY PRIOR TO C.O. WINDOW AND DOOR INSPECTION: *INSTALLATION INSTUCTIONS REQUIRED *ALL STICKERS ARE TO REMAIN ON THE WINDOWS *PROVIDE ACCESS TO ALL WINDOWS TO INSPECT FASTENERS *2007 FLORIDA BUILDING CODE W/2009 REVISIONS NATIONA1 ELECTRIC CODE *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 sewer cleanout must be installed at the property line. PERMIT IS cfleitgiNVAVNLIV49 Affiimitotiltart4 4illfiDilialliCEWW3 THE FLORIDA BUILDING CODES. . 1 , ; . j ,, 0 `` C ITY OF ATLANTIC BEACH s-) 800 SEMINOLE ROAD 0 �:`' "` = ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5814 Page 2 Application Number 11- 00002400 Date 9/01/11 Special Notes and Comments metal lid. Cleanout to be set to grade and visible. Call Public Works (247 -5834) for Erosion and Sediment Control Inspection before beginning any site work. Roll off container company must be on City approved list and container cannot be placed on City right -of -way. Other Fees STATE PLBG DCA SURCHARGE 2.00 STATE PLBG DBPR SURCHARGE 2.00 Fee summary Charged Paid Credited Due Permit Fee Total 125.00 125.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.00 4.00 .00 .00 Grand Total 129.00 129.00 .00 .00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. PLUMBING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach, FL 32233 Ph (904) 247 -5826 Fax (904) 247 -5845 JOB ADDRESS: c ,'�� -� '-e:=0 NEW -.�� PERMIT # // NEW OR REPLACEMENT INSTALLATION: Project Value $ TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY Bathtub i2, Septic Tank & Pit Clothes Washer Shower Dishwasher Shower Pan Drinking Fountain Slop Sink Floor Drain Three Compartment Sink Floor Sink Toilet o. Hose Bibs Urinal Kitchen Sink / Vacuum Breakers Laundry Tray Water Connected Appliances Lavatory Water Heater / Other Fixtures Water Treating System j73 RE -PIPE: TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY Bathtub Septic Tank & Pit Clothes Washer Shower Dishwasher Shower Pan Drinking Fountain Slop Sink Floor Drain Three Compartment Sink Floor Sink Toilet Hose Bibs Urinal Kitchen Sink Vacuum Breakers Laundry Tray Water Connected Appliances Lavatory Water Heater Other Fixtures Water Treating System MISCELLANEOUS: ❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor (Trap) gallons (Requires 3 sets of plans) ❑ Lawn Sprinkler System - Number of Heads ❑ Well ** ** SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection. ** ❑ 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 -13 c - tCit \ r - j4 Cc* Phone Number 2L\ 1 _ \ r ) 9 2 Plumbing Company C.. .. \v.1 ∎ SsYb Office Phone2 - L} Fax (2-L ) -O 9 Co. Address: f::>9 (7 a ` , Q.0- Ci tY `��- � State F I Zip 'm2SO License Holder (Print): -n `Ce . 0 s - State Certi tion/Registration # C cC .142 Notarized Signature of License Holder . /� ■ E 0-4-1.4 2 :ke401;;.. � , , MICHELLE L CREWS Sworn and subscribed before me this ( 2.---P day o Pull 20 \ \ ': . MY COMMISSION # EE037670 ((�� n , ,� ,�," : EXPIRES October 26, 2014 S of Notary Public` e 0 )...,. -DS (407) 398 -0153 FlorldallotaryServka.com .0 CITY OF ATLANTIC BEACH i 800 SEMINOLE ROAD "v% " ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5814 Application Number 11- 00002401 Date 9/01/11 Property Address 54 SIMMONS RD Application type description SINGLE FAMILY ATTACHED DWELLING Property Zoning TO BE UPDATED Application valuation . . . 75000 Application desc NEW SINGLE FAMILY ATTACHED Owner Contractor BEACHES HABITAT 1671 FRANCIS AVENUE ATLANTIC BEACH FL 32233 (904) 241 -1222 Structure Information 000 000 Construction Type TYPE 5 -A Occupancy Type RESIDENTIAL Flood Zone ZONE X Permit PLUMBING PERMIT Additional desc . Permit Fee . . . 125.00 Plan Check Fee . . .00 Issue Date . . . Valuation . . . . 0 Expiration Date . 2/28/12 Special Notes and Comments *2007 FLORIDA BUILDING CODE W/2009 REVISIONS NATIONA1 ELECTRIC CODE *SUBMIT "CERTIFICATE OF COMPLIANCE" BY A LICENSED PEST CONTROL COMPANY PRIOR TO C.O. WINDOW AND DOOR INSPECTION: *INSTALLATION INSTUCTIONS REQUIRED *ALL STICKERS ARE TO REMAIN ON THE WINDOWS *PROVIDE ACCESS TO ALL WINDOWS TO INSPECT FASTENERS *2007 FLORIDA BUILDING CODE W/2009 REVISIONS NATIONA1 ELECTRIC CODE *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 sewer cleanout must be installed at the property line. Cleanout be covered with an RT1 concrete box with PERMIT IS �It6 D'4411' IN S c E NRH kL #c't 1B14 OXIi2$IA 3 Hit AND THE FLORIDA BUILDING CODES. `` sA CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5814 Page 2 Application Number 11- 00002401 Date 9/01/11 Special Notes and Comments Call Public Works (247 -5834) for Erosion and Sediment Control Inspection before beginning any site work. Roll off container company must be on City approved list and container cannot be placed on City right -of -way. Other Fees STATE PLBG DCA SURCHARGE 2.00 STATE PLBG DBPR SURCHARGE 2.00 Fee summary Charged Paid Credited Due Permit Fee Total 125.00 125.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.00 4.00 .00 .00 Grand Total 129.00 129.00 .00 .00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. PLUMBING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach, FL 32233 Ph (904) 247 -5826 Fax (904) 247 -5845 �/ JOB ADDRESS: JL • C j 1�Y1'�Y d � PERMIT # // ` 0 0 / NEW OR REPLACEMENT INSTALLATION: Project Value $ TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY Bathtub 2 Septic Tank & Pit Clothes Washer Shower Dishwasher Shower Pan Drinking Fountain Slop Sink Floor Drain Three Compartment Sink Floor Sink Toilet 2. Hose Bibs Urinal Kitchen Sink / Vacuum Breakers Laundry Tray Water Connected Appliances Lavatory Z Water Heater f Other Fixtures Water Treating System RE -PIPE: TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY Bathtub Septic Tank & Pit Clothes Washer Shower Dishwasher Shower Pan Drinking Fountain Slop Sink Floor Drain Three Compartment Sink Floor Sink Toilet Hose Bibs Urinal Kitchen Sink Vacuum Breakers Laundry Tray Water Connected Appliances Lavatory Water Heater Other Fixtures Water Treating System MISCELLANEOUS: ❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor (Trap) gallons (Requires 3 sets of plans) ❑ Lawn Sprinkler System - Number of Heads ❑ Well * * ** SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection. ** ❑ 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 6Q0, ( 1AOh 04 Phone Number 291-1 222. Plumbing Company © .i_ U Imo _ _ Office Phone 241-'4, Ll 0 Fax 240-9N Co. Address:L6 2 2L • Lic, I k 4 " City k�>L State Zip 2EO License Holder (Print): l r. u s State fication/Registration # older sie:t MICHELLE CREWS *: ':: 20 1 1 ; •c MY COMMISSION # EE037670 Sworn and subscribed Y ore me this day of EXP IRES October 26, 2014 3 Signature of Notary Public P))0,\Q15 (407) ) 388 -0153 FloridallotaryService.com ", 4 CITY OF ATLANTIC BEACH r , ) 800 SEMINOLE ROAD "14 ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5814 Application Number 11- 00002401 Date 12/14/11 Property Address 54 SIMMONS RD Application type description SINGLE FAMILY ATTACHED DWELLING Property Zoning TO BE UPDATED Application valuation . . . 75000 Application desc NEW SINGLE FAMILY ATTACHED Owner Contractor BEACHES HABITAT 1671 FRANCIS AVENUE ATLANTIC BEACH FL 32233 (904) 241 -1222 Structure Information 000 000 Construction Type TYPE 5 -A Occupancy Type RESIDENTIAL Flood Zone ZONE X Permit MECHANICAL HVAC PERMIT Additional desc . INSTALL NEW 2.5 TON SYSTEM Sub Contractor . FLORIDA AIR SERVICE & ENG.LLC Permit Fee . . . 103.00 Plan Check Fee . . .00 Issue Date . . . Valuation . . . . 0 Expiration Date . 6/11/12 Special Notes and Comments *2007 FLORIDA BUILDING CODE W/2009 REVISIONS NATIONA1 ELECTRIC CODE *SUBMIT "CERTIFICATE OF COMPLIANCE" BY A LICENSED PEST CONTROL COMPANY PRIOR TO C.O. WINDOW AND DOOR INSPECTION: *INSTALLATION INSTUCTIONS REQUIRED *ALL STICKERS ARE TO REMAIN ON THE WINDOWS *PROVIDE ACCESS TO ALL WINDOWS TO INSPECT FASTENERS *2007 FLORIDA BUILDING CODE W/2009 REVISIONS NATIONA1 ELECTRIC CODE *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 sewer cleanout must be installed at the property line. PERMIT IS CAY 6NI k CCSRI IRELPW'W i A� ` kITAN'fiP i'IlRDI3S CL 4l THE FLORIDA BUILDING CODES. 0 1 " 414 -/.6, '1 CITY OF ATLANTIC BEACH j 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5814 Page 2 Application Number 11- 00002401 Date 12/14/11 Special Notes and Comments metal lid. Cleanout to be set to grade and visible. Call Public Works (247 -5834) for Erosion and Sediment Control Inspection before beginning any site work. Roll off container company must be on City approved list and container cannot be placed on City right -of -way. Other Fees STATE MECH DCA SURCHARGE 2.00 STATE MECH DBPR SURCHARGE 2.00 Fee summary Charged Paid Credited Due Permit Fee Total 103.00 103.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.00 4.00 .00 .00 Grand Total 107.00 107.00 .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 - Z 1 800 Seminole Rd Atlantic Beach, FL 32233 `� Ph (904) 247 -5826 Fax (904) 247 -5845 / JOB ADDRESS: CL " 55 S (Ai^tioNs R-b PERMIT # / ( 1,1-0D PROJECT VALUE $ 4 ---,q 0 O NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION Air Conditioning: Unit Quantity 2— Tons Per Unit 2 • S Heat: Unit Quantity 2-- BTU's Per Unit Seer Rating 1 Duct Systems: Total CFM WO REQUIRED REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARl # 401 it 3 v Air Conditioning: Unit Quantity 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 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 1 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 Mechanical Company 'f'ca)13bi ,4A S a_cv ce Office Phone `' -C64 ax 4OY- e li- ';4Q Co. Address: IS3 1411 ,v Jib 11,06" f'M' T= J6flf City e ot lea State l-e_ Zip ;Zoe/ License Holder (Prin % 00 Wont • ■ I V S t a t e Certification /Registration # CAc t� '13G 2 ; �••N,MI891 '•• �i Notarized Signatur L• e di te A , / ; "'Skf and subscr sed before m:� • ay of ` 20 1/ :�.• #EE 1212 i''.55,:\ 4.443 , + S ture of Notar , ' ublic � — in. i% IP * iiiiiiiiiiii HP Search Page 1 of 2 111 ono Roveropar mom* q s HP SRarCh Home Modify Export :Double click on a r ow to view /print AHRI certi AHRI certificates are not available for Obsolete AC and HP equipment. (Model Status of'Active' means models are currently in production.'Discontinued' means that the manufacturer has elected to stop producing, yet stock is still available.'Obsolete' means that the manufacturer is required to stop manuh Outdoor Unit Indoor Unit ¢ Cooling High Heating 47 F Low Heating 17 F ( Est. AHRI Model Manufacturer Trade /Brand Manufacturer Furnace 1 Capacity Capacity ! AHRI Exclusively'.. Cemfied Status Type Name - Manufacturer Model (Mix- Match) Model Model (Btuh) EER SEER (B�h) HSPF Capacity (fifth) Phase Type HSVTC For Export ! Ce RefA BASE 13 CARRIER AIR 25HBC330 FX4DN HRCU 3696630. Active Systems PURON HP CONDITIONING (A,IA6 - 30 (O F) 30000 12.00 14.50 30000 8.20 18300 1 -A -CB 7 Now displaying records 1 -1 of 1 total I content u, 11erms - icen:c AHI21 tJlrnorory Data hts w2 Copyright ® 2011 Air - Conditioning, Heating, and R Institute. All rig reserved. http: / /www.ahridirectory.org /ahridirectory /pages /hp /defaultSearch.aspx 12/14/2011