78 Forrestal 2014 HVAC CITY OF ATLANTIC BEACH
SSS
800 SEMINOLE ROAD
MECHANICAL HVAC PERMI-FkTLANTIC BEACH, FL 32233
\ CALL BY 4PM FOR NEXT DAY INSfIETIMCIMTASSONE LINE 247-5814
JOB IN .
ioh TD• 14-M C;H-104
Job Type: MECHANICAL HVAC ONLY
Description: 1 cu 1 ahu 4 tons
Estimated Value:
Issue Date: 10/17/2014
Expiration Date: 4/15/2015
PROPERTY ADDRESS:
Address: 78 FORRESTAL CIR
RE Number: 171754-0000
PROPERTY OWNER:
Name: RIVERA, ROMAN ANA CELIA
Address: 78 S FORRESTAL CIR
GENERAL CONTRACTOR INFORMATION:
Name: FLORIDA HOME AIR COND DBA ARS
Address:
Phone: - -
PERMIT INFORMATION: 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.
FEES:
Heat Exchanger or Coil in Ducts $10.00
AC and Refrigeration $16.00
State Mech DBPR Surcharge $2.00
State Mech DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $85.00
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 (904) 247-5845
.TOB ADDRESS: ( � ���re�-TC�� lC�rc1 e, � PERMIT#
PROJECT VALUE $
NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity Tons Per Unit
Heat: Unit Quantity BTU's Per Unit Seer RatingREQUIREDDuct Systems: Total CFM
REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTTIAL TI, N
Air Conditioning: Unit Quantity j Tons Per Unit iA T REQUIRED
Heat: Unit Quantity�_ BTU's Per Unit Seer Rating I( a ,
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 -Phone Number 900—a 5 -qZb
Mechanical Company �(Or► Grp —Office Phone 11-7` Fax1 7atE6 --
Co. Address: 2 �l1 City State H Zip 3&-33
License Holder (Print): .--` ►- +-� State Certification/Registration# Z ��
Notarized Signature of License Holder
�J
BONNIE R,TURKNETT Sworn and subscribed before me this da 20.
Notary Public,State of Florida
My Comm.Expires May 5,2015 Signature of Notary Public
Commission No.EE 84823