1471 LAUREL WAY 2014 HVAC CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
r) ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 14-00001192 Date 7/25/14
Property Address . . . . . . 1471 LAUREL WAY
Application type description MECHANICAL HVAC ONLY
Property Zoning . . . . . . . RES SF DISTRICT
Application valuation . . . . 0
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Application desc
1 cu 1 ahu
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Owner Contractor
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BACKMANN VALERIE P COMPLETE AIR SYSTEMS
1471 LAUREL WAY 1721 FOREST BLVD
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32246
(904) 268-4486
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Permit MECHANICAL HVAC PERMIT
Additional desc . .
Permit Fee . . . . 115 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 1/21/15
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Special Notes and Comments
STICKER FOR OVERCURRENT PROTECTION MUST
BE ON A/C EQUIPMENT PRIOR TO
INSPECTION. FAILURE TO COMPLY WILL
RESULT IN A FAILED INSPECTION AND
REINSPECT FEES . NO EXCEPTIONS .
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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 115 . 00 115 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 119 . 00 119 . 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
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904) 247-5826Fax (9044))j247-5845
JOB ADDRESS: -! ! LGI(/(� �� fi I/ > >> PERMIT#
PROJECT VALUE $ 100 • C�;b ARI# 3(o-7 (DS W-C REQUIRED
Air Handling Equipment Only Air Handling Unit & Condenser Condenser Only
NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity Tons Per Unit
Heat: Unit Quantity BTU's Per Unit Seer Rating
Duct Systems: Total CFM REQUIRED
REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity�_ Tons Per Unit S /
Heat: Unit Quantity_� BTU's Per Unit S 71o0U 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 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 r,�I i' �m Ga ckmoo Phone Number 90y - 514 �l7
Mechanical CompanyY21A-,,c Sy3S err s ,�v,c Office Phon 'N g Fax�66 a�
Co. Address: h 51 1 Sumn-,Pr '1a brn I >I lyd N City 1 g-C State FCZip Sd
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License Holder(Print): State Certification/Registration# Cly yw)
Notarized Signature of License HolderIsk
LEIQ�iANNA RICEIARDS ,�,
Before me this a`� day of 20.E
,�ypY PUg�
MY COWISSION t EE 069105 Signature of Notary Public 04 VU- 4Z
* EMAES:April 15,2 15
"l171!,woe %,,w Thru Bwo Notary SWAM