176 16th St 2012 gas piping CIT' OF ATLANTIC r NTIC BEACH
j 800 SEMINOLE ROAD
-- ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12 0001073 Date 8/16/12
Property Address . . . . . . 176 ', 16TH ST
Application type description MEC ANICAL GAS PIPING
Property Zoning . . . . . . . TO tE UPDATED
Application valuation . . . . 0
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Application desc
4 gas outlets 1 water heater
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Owner Contractor
CDL AB LLC FLORIDA PROPANE PARTNERS
CHRIS LAMBERTSON DBA:GRIFFIS GAS & MACK GAS
357 12TH ST 115 B SOLANO RD
ATLANTIC BEACH FL 32233 PONTE VEDRA BCH FL 32082
(904) 543-4343
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Permit . . . . . . MECHANICAL GAS PIPE PERMIT
Additional desc .
Permit Fee 70 . 00 Plan Check Fee . 00
Issue Date . . . Valuation 0
Expiration Date 2/12/13
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Other Fees . . . . . . . . . STAIE MECH DCA SURCHARGE 2 . 00
STAIE MECH DBPR SURCHARGE 2 . 00
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Fee summary Charged V aid Credited Due
----------------- ---------- --- ------ ---------- ----------
Permit Fee Total 70 . 00 70 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 74 . 00 74 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF A rLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
MECHANICAL PERMIJF APPLICATION , ?)
CITY OF ATLAN IC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph (904) 247-5826 Fax (9:04) 247-5845
JOB ADDRESS: V PERMIT#
PROJECT VALUE $ ARJ:
REQUIRED
NEW AIR CONDITIONING & HEATING SYSTE INSTALLATION
Air Conditioning: Unit Quantity Tons Per Unit
Heat: Unit Quantity BTU's Per C,nit Seer Rating
Duct Systems: Total CFM REQUIRED
REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity Tons Per Un t
Heat: Unit Quantity BTU's Per t nit 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 y (Requires 3 sets of plans)
Fire Suppression Systems Quantity (Requires 3 sets of plans)
FIRE PLACES MISCELLANEOUS:
Prefabricated Fireplace Qty Autoi nobile Lifts
Gas Piping Outlets Boile s BTU's
Elev ors/Escalators
ALL OTHER GAS PIPI G Heat Exchanger
Quantity of Outlets PUMT s
#Vented Wall Furnaces Refrigerator Condenser BTU's
# Water Heaters Solar Collection Systems
Tank (gallons)
Well
OTHER• Nk
Permit becomes void if work does not commence within a six month period or work is Fuspended 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 o;dinances 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 o' local law regulation construction or the performance of construction.
Property Owners Name Phone Number
�I1
Mechanical Company Office Ph3z Fax
—}�
Co. Address: 6 J r•
Cit}t� �°�_� State
License Holder (Print): State Certification/Registration# � '
Notarized Signature of License Holder
SHIPLEY L.GRAHAM orn and subscribed bef this % ay of 94AGr, J7_ 2012-
t*: MY COMMISSION 4 DD 957760
EXPIRES:February 14,2014 gnature of No Pub
� P;h.•' Bonded Th;O Notary Public Underwriters