59 Shell St (vault) t y.
CITY OF ATLANTIC BEACH
ti
SIS 800 SEMINOLE ROAD
r } ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
`j_�t rJi31�r
06-00033785 Date 8/24/06
Application Number 59 SHELL ST
Property Address . • . • -
Application type description MECHANICAL ONLY
Property Zoning - TO BE UPDATED
0
Application valuation . . • ----
Application desc -
1 CU 1 AHU -
Contractor
Owner __ ----------------
--------- -
------------ OCEAN STATE HEAT & AI
SCHANZ 1476 ATLANTIC BLVD.
59 SHELL STREET NEPTUNE BEACH FL 32266
ATLANTIC BEACH FL 32233
(904) 249-8251 --___------
Permit
---------------------------
_ MECHANICAL PERMIT
Additional desc Plan Check Fee .00
Permit Fee 79 . 00 0
Valuation
Issue Date 2/20/07
-----Expiration Date __ ----
------------------------Paid----
Charged Credited
Fee summary ----------
-------------
---Due---
_ ------------ -----79 . 00 79 . 00 .00
.00
Permit Fee Total 00 00 . 00
Plan Check Total 79 . 00 . 00 . 00
Grand Total 79 . 00
PERMIT
IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANC[C BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES-
Rug 24 06 09: 08a Ocean State A/C 904-249-8949
SL 3
'TIC BEACE
CITE' Off' ATLATN
MF.C.UANICAL PERMIT APPLICATION
Date:
te-
(51 Property Address. W
-"'o
Co 11tracto r-.D.Qe Teiephone
Cotitr:tcto i- address: L4131D-aaL1J d La F a
In cotlSidamcilin of perm Sive .her dQW0. d,c-),k as dLziarfb in the at)ove AutcMent,wc vi:Tct v ugee m pf--nr=said Work in accot-daricz
with Chi:amchvi plaUs atid SpecificaTiOUS which are a pall hereof and in accotclan=with the of Mande Beacb rndittaues and i1alldacds If
_flood_pr=ire listed therein.
Type fiflitatinw.ruiel: It other CMMUUiun-is being done nn tH.4 h6lHi.tjsz
or site,fist the building permit number.
Cl 6as; —TJ' —Natural Z-=-4 Utility
* oil
* Otber-Specify
ECHANICA,L EQIrDK;NT TO 13E INSTALLED NATUM OF'v WORK
Heat w Space Recessed V'Celatral —FICUT a
�AIT Conditioning: Room izitntrul
0 Duct Spaem: Material Thickness Q Commercial
Maximuin capuci.tv cf3l,
,Z1 Xeffi2erutloa New Buil(fing,
Cooling Tower Capacity ")-Pm
E;usting BuildtT.iqq
Tire Sprinkler s:�Nvmber of'Re=z
Nfa)jift- —'Escatular (Number) SVbICIT!
1Z Gasoline 1:'TL7mps _(Number.)
• Tanks (Number) a New Ins:;Iuan on
• LPG Couvimers (Num be-) !No sn-tem.prcv01;41Y imtallccll
C1 Unfbred Prozssure Vessel 0 Extension or Add-ori to&xibUngjyyMem
C1 Gas Piping 0 "(D iT 16i.-speull
Q Other-Specify
LIST ALL E,0
,UIMENT
AM CONDMONING,RZI,-IUGI-:XATI()Ci.IEQUD'MZi-T&CQNMMUR'ti AppOviag
Number Units EitsCrit' n Model 41 Manufacturer Tim'5 Agent
H&1. M;-1-7.rRNACF ,111)(1,ERS.FIRLPLACES&AM HANDLER'$ Approving
Nuinhe-, Uairs Desmipriou .'agency
1/6
fit ii& Fd y ro 0Z
TAtVtCs Nuavinal C`*4civy Typc Liquid
Dinlcnsinns 1"41mitacturcr - --Av�nv,
Soo 5emijikike Runa - Atiatittic Beach!Florida 322.33-34415
.1'hone: (904)24-1-5800 - Fat; (904)'147-5345 -
ft SL 3
e
na+� CITY OF ATLAT'vTIC BEACT
�J 1YMECHAN-ICAL PERMIT APPLICATION
Date:
Property Address: �/ v�
Owner: Telephone#: �41 - 3 �3
n m
Contractor: oCean caune— , C Telephone 9: E - O
Contractor Address: t4-7[p (�TL _�r, Fax4:p4q-q�A-
In consideration of permit given for doing the work as described in the above statement,we hereby agree to perform said work in accordance
with the attached plans and specifications which are a part hereof and in accordance with the City of Atlantic Beach ordinances and standards of
Qood practice listed therein.
Type of Heating Fuel: If other construction is being done on this building
or site,list the building permit number:
O/Electric Iv
Cl Gas: LP Natural Central Utility
❑ Oil
❑ Other-Specify
MECHANICAL EQUIPMENT TO BE INSTALLED NATURE OF WORK
r9o' Heat Space _Recessed . _✓Central _Floor 3--"Residential
Air Conditioning: —Room Zentral
❑ Duct System: Material Thickness Cl Commercial
Maximum capacity efin ❑ New Blinding
❑ Refrigeration
❑ Cooling Tower:Capacity gPm ❑ F--dstins Building
❑ Fire Sprinklers:Number of Heads
❑ Elevator: __ Manlift Escalator (Number) wl"Replacement afE.xisting System
❑ Gasoline Pumps (Number j
❑ Tanks (Number) C1 New Installation
❑ LPG Containers (Number) (No system previously installed)
❑ Unfired Pressure Vessel ❑ Extension or Add-on to Existing System
❑ Boilers ----------.___-- ---- _---
❑ Gas Piping —
❑ Other-Specify
LIST ALL EQUIPMENT
AIR CONDITIONING,REFRIGERATION EQUIPMENT&CONDENSOR'S Approving
Number Units Descniron Model# Manufacturer Ton's Agency
1 �
HEATING—FURNACES,BOILERS,FIREPLACES&.MR HANDLER'S Approving
Number Units Description Model Mania BTUs Agency
l Ahit �o o�
rw,u, 0 6V
TAi`fKS Nominal Capacity Type Liquid Serial Approvmg
How Ivlanv &Dimensions Contained Manufacturer No. Aeencv
800 Seminole Road • Atlantic Beach, Florida 321233-5445
Phone: (904)24;-5800 • Faz: (904) 2-47-5345 . http:!/www.ei.atlantic-beach.fl.us
MEMORANDUM Yage i or i
Hanson, Jim _
From: Ford, Don
Sent: Wednesday, May 21, 2003 8:00 AM
To: Hanson, Jim
Cc: Kosoy, Robert
Subject: Shell St-TreeBoard.doc CC
.13fity commission
❑City Manager
❑City Attorney
MEMORANDUM ❑Press
..P-riie
Date:
Wednesday, May 21, 2003
To: Jim Hanson
From; Don C. Ford
Subject: Tree Board letter to Commission concerning trees on Shell St.
I have met with the Tree Conservation Board Chair person, Barbara Mears, and reviewed the location of
two oak trees approximately0 tast,of Seminole Rd. on the south side of Shell St. The board was
concerned that the paving ofNeIRTaywill cause damage to the trees. The design of the street shows the
pavement has been curved to the north side of the ROW. After discussing the possibility of moving the
pavement further to the north we determined due to the location of a power pole on the north side of
Shell St. it would not be feasible to move the pavement any further to the north. The plans indicate the
pavement will be 1 to 2 feet from the nearest oak( 8 inch DBH).
Ms. Mears agreed that the city had taken appropriate steps in the design to cause as little harm as
possible to the two oak trees.
Cc: Bob Kosoy
5/21/2003
City of- Atlantic Beach
Fixture Unit Worksheet for Water Impact Fee
FIXTURE UNITS ARE ESTABLISHED AS THE MEASUREMENT OF WATER DEMAND
FOR EACH WATER FIXTURE UNIT INSTALLED AND CONNECTED TO THE CITY
WATER SYSTEM. THE WATER SUPPLY CHARGE IS HEREBY FIXED AT TEN
DOLLARS PER FIXTURE UNIT CONNECTED TO THE CITY WATER SYSTEM.
___BATHROOM GROUP CONSISTING OF _____SERVICE SINK TRAP STAND
WATER CLOSET, LAVATORY & BATH (8)
TUB OR SHOWER STALL (6)
WATER CLOSET VALVE
WATER CLOSET, TANK OPERATED (4) ^VALVE OPERATED (8)
BATHTUB/SHOWER (2) -----URINAL WALL LIP (4)
SHOWER GROUP PER HEAD (3) -----FLOOR DRAIN ( 1 )
SHOWER STALL DOMESTIC (2) -_-_-LAUNDRY TRAY (2)
LAVATORY ( 1 ) ___-_COMBINATION SINK AND TRAY (3)
WASHING MACHINE (3) -----POT, SCULLERY SINK (4)
DISHWASHER (2) -----WASH SINK EACH SET OF
FAUCETS (2)
__KITCHEN SINK (2)
DENTAL LAVATORY ( 1)
_____KITCHEN SINK WITH WASTE
GRINDER (3) -____DENTAL UNIT OR CUSPIDOR (1)
BIDGET (3) _____URINAL STALL, WASHOUT (4)
FLUSHING RIM SINK (8) _-___COMBINATION SINK AND TRAY WITH
----- FOOD DISPOS. (4)
_____URINAL, PEDESTAL, SYPHON JET
BLOWOUT (8) --___DRINKING FOUNTAIN ( 1/2)
LAVATORY, BARBER/BEAUTY
----- LAVATORY, SURGEONS (2)
SHOP (2) -----
SURGEONS SINK (3) _____URINAL STALL, WASnOUT(4)
0
TOTAL FIXTURE UNITS___z�___- @ X10. 00 EACH $ / / 0.0_-_-_--
JOB INFORMATION -
APPLICATION FOR WATER AND/OR SEWER TAP
APPLICANT NAME ------------------
MAILING ADDRESS
__/Z27__ r/ ------------
PHONE HUMBER__ � _ J7C)T�-------- DATE_/L:.:�--3 ---------
SERVICE REGUESTED -
-------------------- --------------------------
SERVICE LOCATION_: C� ------- -------------------
----------------- -----------------------
-----------------------------------------------------------
DATE SENT TO DATE RETURNED
PUBLIC WORKSTO BUILD. DPT.
----------------
DATE OWNER
NOTIFIED_____________________
-� -, APR 2 3
1992
Building and Zoning
P
id
5345
DEPARTMENT OF BUILDING
CITY OF ATLANTIC BEACH
---- PERMIT INFORMATION -- - -
- - ----- LOCATION INFORMATION -
Permit Number: 5345 address: 59 SHELL STREET
permit Type: UTILITIES ATLANTIC BEACH, FLORIDA-
Lot: Block : Section:3223 ,
Class of Work : NEW ---------- LEGAL DESCRIPTION -
Constr. Type; CONCRETE Township: RNG: 0
Proposed Use: SINGLE FAMILY
Dwellings: 1 Code: 0 Subdivision:
Estimated Value: $0. 00
Improv. Cost: $0. 00
Total Fees: $344. 33
Amount F';: $344. 33
n
7Address : 1927
R INFORMATION -- --- ---- APPLICATION FEESRANDYPERMIT $0. 00
EACHIDE COURTWAI,ER IMPACT FEE $0. 00
;EWER IMPACT FEE $C3. a�'IC BEACH, FLORID, WATER METER SBS• 00
•-1`x-':'7C
RADON GAS-H. R. S. $0. 00
RADON GAS - 5% $0. 00
L�}p�`t`,?ACT��i INFORMATION WATER TAP 5259. 33
Name: PUBL.TC WORKS DEPARTMENT SEWER TAP $0. 00
Ad jre.:y
HYDRAULIC SHARE 50. 00
L.i :�zne. Type:
RE-INSPECT FEE $0. 00
SEC. H IMPACT FEE $0. 00
OTHF,R. $0. 00
NOTES:
NOTICE —ALL CONCRETE FORMS AND FOOTINGS MUST BE INSPECTED BEFORE POURING
PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE
BUILDING MATERIAL, RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE,AND MUST BE
CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER
"FAILURE TO COMPLY WITH THE MECHANICS'ILDING IMPROVEMENTS,LIEN LAW CAN RESULT IN
THE PROPERTY OWNER PAYING TWICE FOR B
55
ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND
0 A R
VIOLATION OF APPLICABLE PROVISIONS OF LAW.
MAY 1
ATLANTIC BEACH BUILDING DEPARTMENT Building and Zoning
By:
DEPARTMENT OF BUILDING
CITY OF ATLANTIC BEACH
--- PERMIT !N1-'UR!' AI -------- LOCATION INFORMATION ---
eer-mit Number : 4778 Address: 59 SHELL STREET
Permit Type: RE-ROOF ATLANTIC BEACH, FLORIDA
Class of Work : NEW ---------- LEGAL DESCRIPTION
Block : Section :
Constr. Type: WOOD FRAME Lot:
Proposed Use: SINGLE FAMILi Township: RNG: 0
Dwellings: I Code: 0 Subdivision:
Estimated Value: $0. 00
Improv. Cost : $0. 00
Total -Fees: $45. 00
Amouft-t. $45. 00
'1/92
ROOF WITH
---- APPLICATION FEES
OWNER INFLJHMATION PERMIT $45.00
5EURC-E GRANDY WATER IMPACT FEE,,_, $0.00,
59 SHELL STREET SEWER IMPACT FEE $0. 00
A 1,TLANTIC REACH, FLORI WATER METER 40.00
03(:}4.)2,1149-7' 04 RADON GAS-H. R. S. $U. 00
NFORMATTO�l RADON GAS - 5% $0. 00
CONTRACTOR I WATER TAP $0. 00
Name: PROPERTY OWNER SEWER TAP $0. 00
Address; HYDRAULIC SHARE $0. 00
Type: RE-INSPECT FEE $0. 00
Licenses SEC. H IMPACT FEE , $0. 00
OTHER $0100
NOTES:
NOTICE —ALL CONCRETE FORMS AND FOOTINGS MUST BE INSPECTED BEFORE POURING
PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE
BUILDING MATERIAL, RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE,AND MUST BE
CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER
"FAILURE TO COMPLY WITH THE MECHANICS' LIEN LAW CAN RESULT IN
THE PROPERTY OWNER PAYING TWICE FOR BUILDING IMPROVEMENTS."
OVEMENTS.55
ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF THIS PERMIT AND SUBJE._ t REVOCATION FOR
h"
VIOLATION OF APPLICABLE PROVISIONS OF LAW. iEN6*ERs 946363
ATLANTIC BEACH BUILDING DEPARTMENT
By:
CITY OF ATLANTIC BEACH
PERMIT APPLICATION ROOFING
owner(s) : CS i-
Address: S 61 Phone:
24 -7
Lot # Block or Unit # Subdivision
Contractor:
Address: Phone:
State License No.
Describe work to be done: NF \f f 1..0,0 P
Materials to be used:
Signature OWNER: Date: �q Iq 2-
Signature
Signature CONTRACTOR:
OWNER BUILDER PERMIT AFFIDAVIT--`""
State of Florida
City of Atlantic Beach >
BEFORE ME, the undersigned authority, personally appeared
- (�1/�1Y72vI- 2 ......... who uponfir,ot being duly
sworn, deposes an says:
I� h� l,t Gt bJ' --, and the legal
-- - -- --------------
owner of the ;following property:
Subdivision __ ------ --- -- ---- -------
Block --------------- Lots,_
AKA „j.�� t.L1c_`�T.---_fes --
I am applying for a building permit pursuant Lo %.he Owner
Builder exemption not forth in Florida Statute, Section 483. 103.
Florida law requires that I have been provided with the following
DISCLOSURE STATEMENTS
DISCLOSURE STATEMENT
•State law requires construction to be done by licensed
contractors. You have applied for a permit under an
exemption to that law. The exemption allows you, as
the owner of your property, to act as your own
contractor even though you do not have a license. You
must supervise the construction yourself. You may
build or improve a one - or two family residence or a
farm outbuilding. You may also build or improve a
commercial building at a cost of 925, 000. 00 or less.
The building must be for your use and occupancy. It
may not be built for sale or lease. If you sell or
lease more than one building you have built yourself
within one year after the construction is complete, the
law will presume that you built it for sale or lease,
which is a violation of this exemption. Your
construction must be done according to building codes
and zoning regulations. It is your responsibility to
wake sure that people employed by you have licenses
required by state law and by county or municipal
licensing ordinances.
I hereby acknowledge that I have read the above DISCLOSURE
STATEMENT and that I comply with all the requirements for the
issuance of an Owner-Builder permit.
Further, affiant sayeth not.
L1
Property finer -� ---
Savor o and subscribed
o me this ------ day
unr.ov o�rnr Tr
CITY OF
j 444---- Bwzc4-414 '
Office of Building Official
REQUEST FOR INSPECTION �1
(j Permit No. `t '7/
Date t0
Time �, P District No.
Received 59�
Locality
Jo Ad rens
Owner's Con
S
Name PLUMBI G ECHANICA
BUILDING CONC ETE Rough ❑ Air.Cond.& ❑
Framing ❑
Footing ❑ Rough Wiring El Rough
Re Roofing ❑ Slab ❑ Temp Pole Tap Out ❑ Fire Piece ❑
Lintel ❑ Pre Fab
READY FOR INSPECTION A.M.
W __---P.M.
Mon. Tues. ed. rs.
A.M.
Friday.
InspectionMade
��� �--" Finallnspectio ❑
Inspector
Certificate of Occupancy
Date
CITY OF ATLANTIC BEACH, FLORIDA
Acv'owdby APPLICATION FOR ELECTRICAL PERMIT
TO THE CHIEF ELECTRICAL INSPECTOR: DATE:—�� 19
IMPORTANT NOTICE:
IN CONSIDERATION OF PERMIT GIVEN FOR DOING THE WORK AS DESCRIBED IN THE FOLLOWING. WE
HEREBY AGREE TO PERFORM SAID WORK IN ACCORDANCE WITH THE ATTACHED PLANS AND SPECIFICATIONS,
WHICH ARE A PART HEREOF, AND IN ACCORDANCE WITH THE ELECTRICAL REGULATIONS, CODES AND CITY OF
ATLANTIC BEACH ORDINANCES.
BILL THOMPSON ELECTRIC CO., INC.
P. 0. BOX 50398
JACKSONVILLE BEACH, FL 32240=0398
ELECTRICAL FIRM: MASTER ELECTRICIAN14"ATURE JOURNEY
NAME.,��C,- ADDRESS: Sf / > % RFD BOX
BLDG.SIZE 7BETWEEN:
RES.'r,4- APT.( ) Comm.( ) PUBLIC I ) INDUS.( ► NEW( ) OLD REW. ( )
ADDITION( ) TRAILER ( ► TEMP.f ► SIGNS ( ) SO.FT.
SERVICE: NEW( ► INCREASE REPAIR ( ► FEE
CONDUCTOR SIZE AMPS COPPER ALUM.De4
SWITCH OR BREAKER �S ��AMPS PH >W 4 LrCVQLT RACEWAY ,
EXIST.SERV.SIZE AMPS PH • �W ;VOLT RACEWAY l ��
FEEDERS 1118. SIZE IND. SIZE NO. SIZE
LIGHTING OUTLETS CONCEALED OPEN TOTAL
RECEPTACLES CONCEALED OPEN TOTAL
0.30 AMPS. 31.100 AMPS.
SWITCHES
INCANDESCENT
FLUORESCENT&M.V.
FIXED 0.100 AMPS. OVER
APPLIANCES _ BELL TRANSF.
AIR H.P.RATING H.P.RATING
CONDITIONING COMP.MOTOR OTHER MOTORS AMPS CEIL HEAT: KW-HEAT
0'1 OVER
MOTORS N.P. VOLTAGE PHS NO. 1 H.P. VOLTAGE PHS
MIS ELLANEOUS , 77
CITY OF ATLANTIC BEACH, FLORIDA
Approved by APPLICATION FOR ELECTRICAL. PERMIT
TO THE CHIEF ELECTRICAL INSPECTOR: DATE: 194
IMPORTANT NOTICE:
IN CONSIDERATION OF PERMIT GIVEN FOR DOING THE WORK AS DESCRIBED IN THE FOLLOWING, WE
HEREBY AGREE TO PERFORM SAID WORK IN ACCORDANCE WITH THE ATTACHED PLANS AND SPECIFICATIONS,
WHICH ARE A PART HEREOF, AND IN ACCORDANCE WITH THE ELECTRICAL REGULATIONS, CODES AND CITY OF
ATLANTIC BEACH ORDINANCES.
BILL THOMPSON ELECTRIC CO., INC. ����
-)0'5W) R 0. BOX 50398
h c^ , , ,
ELECTRICAL FIRM:' MASTER ELECTRICIAN GNATURE
NAME Q UA2P. ADDRESS: F� S c \\ S+def i-RFD BOX
BLDG.SIZE BETWEEN:
RES.(') APT. ( 1 comm. ( 1 PUBLIC ( 1 INDUS. ( 1 NEW ( ! OLD ( 1 REW. ( )
ADDITION ( ) TRAILER ( 1 TEMP. ( 1 SIGNS ( ) SQ. FT.
FEE
SERVICE: NEW( 1 INCREASE ( 1 REPAIR (z
CONDUCTOR SIZE AMPS COPPER ( 1 ALUM. 1 1
SWITCH OR BREAKER AMPS PH W VOLT RACEWAY
EXIST.SERV.SIZE AMPS PH W DOLT RACEWAY
FEEDERS NO. SIZE NO. SIZE NO. SIZE
LIGHTING OUTLETS CONCEALED OPEN TOTAL
RECEPTACLES CONCEALED OPEN TOTAL
0-30 AMPS. 31.700 AMPS.
SWITCHES
INCANDESCENT
FLUORESCENT&M.V.
FIXED 0.100 AMPS. OVER
BELL TRANSF.
APPLIANCES
AIR H.P. RATING H.P. RATING
CONDITIONING COMP.MOTOR OTHER MOTORS AMPS CELL HEAT: KW HEAT
0.1 OVER
MOTORS H.P. I VOLTAGE PHS NO. 1 H.P. VOLTAGE PHS
MISCELLANEOUS '
4691
DEPARTMENT OF BUILDING
CITY OF ATLANTIC BEACH
--- PERMIT INFORMATION LOCATION INFORMATION --------
��ddress: 59 SHELL STREET
Permit Number: 4691 T�dd A 3223--
r.-S ATLANTIC BEACH, FLORIDA 32232
Permit Type: MECHANICAL .....
----------- LEGAL DESCRIPTION -------- -
Class of Work : ADDITION L. Block: Section :
Constr. Type: WOOD FRAME Lot : Township: RNG: 0
Proposed Use: SINGLE FAMILY
Dwellings: I Code: 0 $0. 00 Subdivision:
Estimated Value: $0. 00
Improv. Cost : $43. 00
Total Fees : $43. 00
Amount Paid :
APPLICATION FEES
INFORMATION ------- PERMIT $43. 00
Name: GRANDY WATER IMPACT FEE $0. 00
'ame
e 59 SHELL STREET $0. 00
Address: ATLANTIC BEACH, 22 SEWER IMPACT FEE $0. 00
WATER METER
0. U0
(gC)4 )249-8251 FLORIDAR.1 DA- 32 RADON GAS-H. R. S. $0. 00
APPLICATION
FEES -- --
$43- 00
'EE $0. 00
,r F
T FEE
" I i1r,
RADON GAS - 5% $0. 00
------- CONTRACTOR INFORMATION WATER TAP $0. 00
Name: OCEAN STATE HEAT & 7AIR SEWER TAP $0. 00
address: 1476 ATLANTIC BLVD. 2 HYDRAULIC SHARE $0. 00
NEPTUNE BEACH, FLORIDA 322-3
RE-INSPECT FEE $0. 00
,icense: MHAR-786 Type. 3 SEC- H IMPACT FEE $0. 00
OTHER
$0. 00
NOTES:
��7
NOTICE —ALL CONCRETE FORMS AND FOOTINGS MUST BE INSPECTED BEFORE POURING
PERMIT VOID SIX MONTHS AFTER DATE OF ISSUE_.
BUILDING MATERIAL, RUBBISH AND DEBRIS FROM THIS WORK MUST NOT BE PLACED IN PUBLIC SPACE,AND MUST BE
CLEARED UP AND HAULED AWAY BY EITHER CONTRACTOR OR OWNER
LAW CRESULT
6'FAILURE TO COMPLY WITH THE MECHANICS' LIEN IMPRAN IN
OVEMENTS.53
THE PROPERTY OWNER PAYING TWICE FOR BUILDING
HIS PERMIT AND SUBJECT TO FOR
ISSUED ACCORDING TO APPROVED PLANS WHICH ARE PART OF T REB $43.00
VIOLATION OF APPLICABLE PROVISIONS OF LAW. �:,';=-
RECEIPT NLKR: 045226
ATLANTIC BEACH BUILDING DEPARTMENT
BUILDING AND ZONING INSPECTION DIVISION
CITY OF ATLANTIC BEACH
ATLANTIC BEACH, FLORI.A 32233
APPLICATION FOR MECHANICAL PERMIT CALL-IN N BER
IMPORTANT — AAp__plicant to complete all items in sections I, II, III, and IV.
I� Street Address: ���LL� �,,,]f
LOCATION —"
OF Intersecting Street$. Between And
BUILDING
Subdivision _. . --- --.----
II. IDENTIFICATION — To be completed by all applicants
In consideration of permit given For doing the work as described in the abcve statement we hereby agree to Fe,fc,� said wo•i e.:c oe :e
with the attaclLed plans end specifications which are a pert hereof and in accordance witn the C ty of Jacksomv.Te ordnamces a^o s e^oe as
of qood practice listed therein.
Name of Mechanical Contractors
Contractor (Print) Master �� 0
Name of
Property Owner
Signature of owner Signature of
Architect or Engineer
or Author4ed Agent
Ill. GENERAL INFORMA `'-
A. Type of Mating fuel: (3.
IS OTHER CONSTRUCTION BEING DONE ON
0 Electric THIS BUILDING OR SITE?
❑ Ges—❑ LP ❑ Natural ❑ Central Utility
IF YES, GIVE NUMBER OF CONSTRUCTION
❑ Oil PERMIT �-----
Q Other — Specify
IV. M mANWAL EQUIPMENT TO BE INSTALLED NATURE OF WORK
(Provide complex list of components on beck of this form) Residential or (] Commercial
Heat ❑ Space ❑ Recessed 19, Central O Floor New Building
A;r : ❑ Rooms Condtt;on;n9 Cemtref Existing Building (U
�
Duct System: Material '
;ckmes� ❑ Replacement of existing system
[ ' New Installation(No system previously installed)
Ma1;m4m capacity �'� C.f.m.
❑ Extension or add-on to existing system s
❑ Refrigeration
❑ Other — Specify
❑ Cooling tower: Capec;ty 9 P ms•
Q Fin tprinklen: Number of It" -
Q Elevator ❑ Monl;ft ❑ Escalator Inumber) THIS SPACE FOR OFFICE USE ONLY
❑ Gasoline Pumpe (number) ( ,)
i
❑ Tenkt (number) Remarks
❑ LPG containers_ —(number) --
❑ Unfired pressure visual
Permit Approved by De'I+
Q 50;16"
Permit Fee
[] Other — Specify
LIST ALL EQUIPMENT
AIR CONDITIONING AND REFRIGERATION FQUIPMENT Capacity Approvlr4
Number Units Description Model Number Manufacturer ('i'ocra) A�aney
cz 7 74 i2 A2