Permit Fireplace 169 Poinsettia 2012 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
- ------0 INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-00000814 Date 6/29/12
Property Address . . . . . . 169 POINSETTIA ST
Application type description MECHANICAL GAS PIPING
Property zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 1800
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Application desc
INSTALL PREFAB FIREPLACE
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Owner Contractor
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-DAVID-G-&-ROWE-DEBORAH S SETZERS & COMPANY
169 POINSETTIA ST 7660 PHILLIPS HIGHWAY
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32241
(904) 731-4100
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Permit . . . . . . MECHANICAL GAS PIPE PERMIT
Additional desc . . INSTALL PREFAB FIREPLACE
Permit Fee . . . . 85 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 12/26/12
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Other Fees . . . . . . . . . STATE MECH DCA SURCHARGE 2 . 00
STATE MECH DBPR SURCHARGE 2 . 00
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 85 . 00 85 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 89 . 00 89 . 00 . 00 . 00
PER41T 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: PERMIT#
PROJECT VALUE $
NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity Tons Per Unit
Heat: Unit Quantity- BTU's Per Unit Seer Rating REQUIRED
Duct Systems: Total CFM
REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION
ARI#
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)
Com M� ercial 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 I have read
this applicat1on 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 perfonnance of construction.
Property Owners Name If- 1-ow 9 Phone Number
Office Phone Fax
Mechanical Company
Z
Co. Address: -7 G city Iu- State R, Zip
istration# 05�lf
License Oolder (Print): I 16,pn SWc-Ce�ification/Reg
Notarized Signature of License Hol
is
!�-,f7-.--�worn and subscribed bef day of
ore
DEBORM AMANDAIN.Lif 11
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Signature of Notary P
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