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1872 Hickory Ln 2014 HVAC CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 Application Number . . . . . 14-00001209 Date 7/29/14 Property Address . . . . . . 1872 HICKORY LN Application type description MECHANICAL HVAC ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 -------------- ------------------------------------------------------------- Application desc 4 tons 48K btu' s ----------------------------------------------------- Owner Contractor ------------------------ COOL CHANGE HEATING & AIR PIERSON 4596 HARBOUR CT NORTH 1872 HICKORY LANE FL 32225 JACKSONVILLE BEACH FL 32250 JACKSONVILLE (904) 571-1944 ---------------------------------------------------------------------------- Permit . . . . . . MECHANICAL HVAC PERMIT Additional desc - - 107 . 00 Plan Check Fee . 00 Permit Fee . . . . Valuation . . . . 0 Issue Date . . . . Expiration Date . . 1/25/15 --------------------------------------------------------------------- ------ 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. --------------- ------------------------------------------------------------ Other Fees . . . . . . . . . STATE MECH DCA SURCHARGE 2 . 00 STATE MECH DBPR SURCHARGE 2 . 00 - -------------------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 107 . 00 107 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 111 . 00 111 . 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) 247-5826 Fax (904) 247-5845 JOB ADDRESS: 1872 HICKERY LN. PERMIT# PROJECT VALUE $ 3,095 ARI# 4626355 _REQUIRED Air Handling Equipment Only X 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 I Tons Per Unit 4 Heat: Unit Quantity I BTU's Per Unit 48000 Seer Rating 13 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 commenceii a six month period or work is suspended or abandoned for six months.I hereby certify thatl have read this application and know the same to be true and correct. All provisions of laws and ordinances governing this work wiu be complied with whether specified or not. The pennit does not give authority to violate the provisions of any other state or local law regulation construction or the perforniance of construction- Property Owners Name Dan Pierson —Phone Number 891-2618 Mechanical Company Cool Change Heating&Air LLC —Office Phone 904-571-1944 Fax 904-928-9261 Co. Address: 4596 Harbour North Ct City Jacksonville State FL Zip 32225 License Holder(Print): Manson L McClain State Certification/Registration# CAC1816300 Notarized Signature of License Holder \ii N C E N T B C.N1,0 -,"OTefore me this day of 20 Vi#EE 17404 F;Ai��u�-y 23,20116 ic ignature of Notary Publ .-3, .70!9 STATE OF FLORIDA DEPARTMENT OF BUSINESSAND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 MCCLAIN, MANSON LEE JR COOL CHANGE HEATING &AIR LLC 4596 HARBOUR NORTH COURT JACKSONVILLE FL 32225 Congi-a ons! With this license you become one of the nearly "a"i isiness and o mg ne lion Floridians licensed by the Department of BL STATE OF FLORIDA Professional Regulation. our professionals and businesses range NESS AND from architects to yacht brokers,from boxers to barbeque restaurants, DEPARTMENT OF BUSI and they keep Florida's economy strong. PROFESSIONAL REGULXnON Every day we work to improve the way we do business in order to CAC1816300 ISSUED: 06110/2014 serve you betteL For information about our services,please log onto www.myfloridaiicense.com. There you can find more information CERTIFIED AIR COND CONTR about our divisions and the regulations that impact you,subscribe MCCLAIN,MANSON I FE JR to department newsletters and learn more about the Departments COOL CHANGE HEATING&AIR LLC initiatives. Our mission at the Department is:License Efficiently,Regulate Fairly. We constantly strive to serve you better so that you can serve your IS CERTIFIED under the provisiOnS of Ch.489 FS. customers. Thank you for doing business in Florida, Expkationdate:AUG31,2016 1-14061owowsa and congratulations on your new license! DETACH HERE KEN LAWSON,SECREIARY RICK SCOTr,GOVERNOR STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD to CAC11116300 ............ !,'�SS B AIR CO The C i................................................ N01 1 IiI011111111ING CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31,2016 IMNE MCCLAIN, MANSON LEE JR COOL CHANGE HEATING&AIR LLC 4596 HARBOUR NORTH COURT JACKSONVILLE FL 32225 -RP ISSUED: 0611012014 DISPLAY AS REQUIRED BY LAW sEQ# 1-1406`100000958 DATE WMMDMV" 07/2 CERTIFICATE OF LIABIUTY INSURANCE 0/14 HIS CERTIFICATE IS ISSUED AS A MATTER OF I FORMATION ONLY ROLPRODUCER AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS E Eina C Coble Insurance Agancy CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE 6 6011-8 103rd Street COVERAGE AFFORDED BY THE POLICIES BELOW. Jacksonville,FL 32210 INSURERS AFFOR—'—-01104kniz- NAIC IN Cypress Property ally insurance INSURED I a CCO 0 1-8 10 Ja vil DUCCR b 'n-Tan -Apt Street le'FL 32210 INSURED IN ea Cool Change Heating&Air,LLC INSURER C: 4596 Harbour North Ct Jacksonville,FL 32225 INSURER E� COVERAGES ............ —lp10iG,0ED- 'j'6ii' ITHSTANDING )EDTO THE INSURED 1%!,jAED ABOVE FOR THE POLIG MAY THE POLICIE;OF INSURANCE LISTED BELO HER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE�Ay BE ISSUED OR ANY REQUIREMENT.TERM OR CONDITION OF ANY CONTRACT OR OT IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN POUCIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LMITS POLICY EFFE NSR ADD TyPEOPINSURANCE POLICY NUIABER DATE D DATE OCCURENCE $1,000am LTR am GENERALLIABILITY o7/20/2014 072 15 EACH GFL-1007169 DAMAGETO RENTED $1 00'Q00 A 0 PREMISES aoocurrerbcs 0 COMMERICAL GENERAL LIABILITY MED EXP(Any—pemon) s5,000 [30 CLAIMS MADE ED OCCUR PERSONAL&ADV INJURY $1,000.000 0— GENERAL AGGREGATE $2,000,000 0— PRODUCTS-COMPIOP AGG $2,000,000 GE1,rL AGGREGATE LIMIT APPLIES PER: $ POUCY[]PROJECTO LOC COMBINED SINGLE LIMIT s 0 AUTOM013LE LIABILITY (Each occurrence) 0 ANY AUTO ODDLY INJURY 0 ALL OWNED AUTOS (Per Person) SC14EDIJLED AUTOS BODILY INJURY HIRED AUTOS (per accidanq NON-OWNED AUTOS PROPERTYDAMAGE $ 0— (Per accident) AUTO ONLY-FA ACCIDENT S GARAGE LIABILITY OTHER THAN EA ACC S 0 ANY AUTO AUTO ONLY: AGO $ EACH OCCURRENCE S EXCESSIUMBRELLA LIABILITY A TE S OCCUR 0 CLAIMS MADE S S 0 DEDUCTIBLE S 0 RETENTION $— WCSU 1 0 OTH' WORKERS COMPENSATION AND TORY ER EMPLOYERS'LIABIL17Y EL.EACH ACC93ENT ANY PROPRIETOR/PARTNERIEXECU- E.L.DISEASE-EA EMPLOYEE TWE Or-FrCER/MEMBER EXCWDED? 9 yes.describe under E.L DISEASE-POLICY LIMIT $ SPECIAL PROVISIONS below 0 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS f VE 11 M 11 CLES i E)(CLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS d representatives are included as an additional insured as 'Me Board ofTrustees ofthe University of Alabama,its individual trustees,officers,directors,employees,agents an ciCS waive the right to recovery or subrogation against ial General Liability and Excess/Umbrella Liability policies.Unless precluded by law,all Poli respect to the Commerc of Alabama,its individual trustees,officers,directors,employees,agents and representatives. the Board of Trustees of the University Insert Contract or Purchase Order#(Job Decscription,if Applicable) CANCELLATION CERTIFICATE HOLDER SHOULD THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE INSURER AFFORDING COVERAGE WILL ENDEAVOR TO City of Atlantic Beach THE CER-nFIC;ATE HOLDER NAMED,To THE LEFT.BUT NAIL 3_0 DAYS WRITTEN NOTICE TO ONTHE goo Stminol Rd. fAILURETO 00 so SMALL IMPOSE No osur.Anowi OR UABILrTY OF AMY KIND UP Atlantic Beach,FL 32233 INSUREK ITS AGENTS OR REPRESENTATIVES. ORFZED REP FSENTA, (p ACORD CORP R N 1988 ACORO 25 JZUU1108)