1735 Selva Marina Dr HVAC "SS CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
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MECHANICAL HVAC PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATI:)N:
Job ID: 14-MECH-651
Job Type: MECHANICAL HVAC ONLY
Description: 4 ton
Estimated Value:
Issue Date: 12/12/2014
Expiration Date: 6/10/2015
PROPERTY ADDRESS:
Address: 1735 SELVA MARINA DR
RE Number: LOC ID-0000
PROPERTY OWNER:
Name: SHORE, BRENT D
Address: 1735 SELVA MARINA DR
GENERAL CONTRACTOR INFORMATION:
Name: APPLIANCE TECHNOLOGIES & AIR
Address: 1989 BRISTA DE MAR BRUCE ALLEN BROMMER
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:
Furnaces and Heating $20.00
AC and Refrigeration $32.00
State Mech DBPR Surcharge $2.00
State Mech DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Furnaces and Heating $20.00
AC and Refrigeration $32.00
State Mech DBPR Surcharge $2.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
UTILDING CODES.
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
State Mech DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $222.00
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: jir-Lo e� Xptmvt 4� PERmrr#
PROJECT VALUE $ ��()- 0 0 7 4' -- ARI# 3 6 5-02 lao UIRED
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 _V/—11"j Seer Ratin
Heat: Unit Quantity BTU's Per Unit 9—��---Icb�
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 rwo—nth period or work is suspended or abandoned for six months.I hereby certify that 1 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.
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Property Owners Name 5W012 C Phone Number
Office Phon�'(?-ZF/31 Fax
Mechanical Company
Co. Address: 19k'� t2til� 49S city A7)"-'7C- 6- "'k,-jtate—?�Zip
License Holder(Print): 16R J- 61?ow mjq���e C�erfifiic�ation/�Registration# 6/11f03- 20?3
Notarized Signature of License Holder
y 0
JENNIFER WALKER Before me this �a 'o 20
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EXPIRES:ApdI 24,2017 Signature of Notary Public
Bonded Thru NotaTY POW underwMers