1874 Tierra Verde Drive Mech Gas 2012 (2) CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
oil
Application Number . . . . . 12-00001491 �! Date 10/10/12
Property Address . . . . . . 1874 TIERRAIVERDE DR
Application type description MECHANICAL OAS PIPING
Property Zoning . . . . . . . PLANNED UNIT DEVELOPMENT
Application valuation . . . . 0
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Application desc
gas fireplace
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Owner Contractor
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HANBURY DAVID AND BRENDA SETZtRS & COMPANY
1874 TIERRA VERDE DR 76601PHILLIPS HIGHWAY
ATLANTIC BEACH FL 32233 JACK80NVILLE FL 32241
(904) 731-4100
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Permit . . . . . . MECHANICAL GAS PIPE PERMIT
Additional desc
Permit Fee . . . . 85 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 4/08/13
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Special Notes and Comments
issued separate permit from sfr could
not get the dca and dpbr fees to
calculate correctly
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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
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALI, 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: I y'? q 7-
e- PERMIT#
PROJECT VALUE $ ( W(0.
NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity Tons Per Unit
Heat: Unit Quantity BTU's Per Unit Seer Ratin
Duct Systems: Total CFM
REQUIRED
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)
Commercial Hoods Quantity (Requires 3 sets of plans)
Fire Suppression Systems Quantity (Requires 3 sets of plans)
FIRE PLACES MISCELLAI�EOUS:
Prefabricated Fireplace Qty- Automobile Lifts
Gas Piping Outlets Boilers BTU's
Elevators/Escalators
ALL OTHER GAS PIPING Heat Exchanger:
Quantity of Outlets Pumps 1
#Vented Wall Furnaces Reffigerator Condenser BTU's
#Water Heaters Solar Collectiod 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 pen-nit 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 Qznl Z 0 Phone Number o?
Mechanical Company Office Phone7
-���to�Fax 730-JCy1;.t-
Co. Address:-�CoLno 4)11,la City State FLzip -3,a-93
License Holder (Print): Wj t-7�kiead State-CAO"cationLRgaistration# 0,5 9PJ
Notarized Signature of License Holder
Sworn and subscribed b f Mree this 10 day of 0C-VDV0e
e o —20k �
-MME S.AKERS
Signature of Notary Public
X?*7A'TA CommL%slon#!EE 13318]
��i Exores Septembw:26,2015