227 BEACH AVE MECH C, , CITY OF ATLANTIC BEACH
l 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
MECHANICAL GAS PIPE PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 14-MCHG-558
Job Type: MECHANICAL GAS PIPING
Description: MECH GAS 1 TANK 90 AG
Estimated Value:
Issue Date: 12/4/2014
Expiration Date: 6/2/2015
PROPERTY ADDRESS:
Address: 227 BEACH AVE
RE Number: 170189-0000
PROPERTY OWNER:
Name: GOODEN TRUST, CORKIE
Address: 4216 POINT LA VISTA RD
GENERAL CONTRACTOR INFORMATION:
Name: WESTERN NATURAL GAS COMPANY
Address: 2960 STRICKLAND ST
Phone: - -
FEES:
Gas Pipe Outlets $10.00
State Mech DBPR Surcharge $2.00
State Mech DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $69.00
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(904J) 247--5/8,26 Fax (904) 247-5845
JOB ADDRESS: �� Q�J , H '! �- i c, �C�- -�aZ3B PERMIT
PROJECT VALUE $ ARI# 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
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 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 r Solar Collection Systems
( �Tanks (gallons) D
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 -,IG�Y��cP. �74��etr1 Phone Number
Mechanical Company oj2:6&ro 66 -�- ev- Office Phone3�735-11 Fax 3 ff 1-(003q
Co. Address: 7�f�0 6-hr��ckl� s4 � City`�G 5��' < <�state > Zip 3)ZSR/
License Holder(Print): �1~ /� w State Certification/Registration# 04 W3,4
Not
WILLIAM T TATE �� 20
z Notary Public-State of fiorib ore me this / day of / �� ��
My Comm.Expires Aug 7,2016
'••.;,off ��;• Commission#EE 223135 Si nature of Notary Publi� 4x�—