1925 Sevilla Blvd 2015 HVAC j1'j-
CITY OF ATILANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
MECHANICAL HVAC PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-MECH-360
Job Type: MECHANICAL HVAC ONLY
Description: 1 CU 1 AHU 4 TONS
Estimated Value:
Issue Date: 2/19/2015
Expiration Date: 8/18/2015
PROPERTY ADDRESS:
Address: 1925 W SEVILLA BLVD
RE Number: 169462-0165
PROPERTY OWNER:
Name: GROFF, HARRY J
Address: 1925 W SEVILLA BLVD
GENERAL CONTRACTOR INFORMATION: R COND DBA ARS
Name: FLORIDA HOME Al IS M BROWN
Address: 4211 EMERSON ST QA DENN
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 $28.00
AC and Refrigeration $64.00
State Mech DBPR Surcharge $4.00
State Mech DCA Surcharge $4.00
Trade Permit Base Fee $110.00
Total Payments: $210.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
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CIT�OF ATLANTIC BEACH
Boo SEMINOLE RD
ATLANTIC BEAC,FL 32233 163114
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CREDIT CARD
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CARD 0005
CITY OF ATLANTIC BEACH INVOICE 0005
800 SEMINOLE ROAD - ')-�Q SEQ 000034
ATLANTIC BEACH, FL 32D,
PHONE (904) 247-5855 Bab 063BA6
Awroval Cok Mawal
Cashier Id: aspcust\atibbia Ent,Meihod� 000
Receipt Date: 2/18/2015
0 MA� $0,00
Receipt �jumber: OC-66128
-MECH-360 - 1 CU I AHU 4 TONS 01 Tax Amfflt
job ID: 15 Cust CO&
G - Furnaces and Heating $28-00 Card Codc M
Job ID: 13-MECH-360 - 1 CU t AHU 4 TONS M2 �210'00
- AC and Refrigeration $64.00 SAE WON
job ID: 15-MECH-360 - 1 CU I AHU 4 TONS MD
BPR - State Mech DBPR Surcharge $4.00 1 agree to pay aboVe tota�aMOUlt
7CH-360 - I CU i AHU 4 TONS MD j-rq to ca(dllssuef agl eenvnt-
Job !D: 15-ME $4.0n
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CA Sta ch DCh rcharge ageement if Credit VOLOU)
job ID' 15-MECH-360 I CLI I AHU 4 TONS TP
$110.00
- Trade Permit Base Fee
Amount Due: $210-00
Tender information: Cash $210.00
Tender Type: CC
Tender Am
mount: $210.00
Change Due: $0-00 MERCHANT COP,
FEB/18/2015/WED 09: 01 AM FAX No, P. 002
MECHANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904) 247-5826 Fax(904)247-5845
Z� V RMIT
J013 ADDRESS: PE #
PROJECT VALUE $ 'YP
NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity, Tons Per Unit .
Heat: Unit Quantity BTU's Per Unit Seer Rating REQULRED
Duct Systems- Total CFM
REPLACEMINT AIR CONDITIONING & HEATING SYSTEM INSTALLATION
AM 4
Air Conditioning: Unit Quantity Tons Per Unit UIREP?�
'%Q&
Heat: Unit Quantity BTU's Per Unit Seer Ratin 1 '3-
Duct Systems: Total CFM REQUYRED
FIRE PREVENTION
Fire Sprin1deT 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 PlIns)
Fire Sappression'Systems Quantity (Requires 3 sets of plans)
FIRE PLACES NUSCELLANEOUS:
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 woI—does not commence within a six month period or work is suspen(Gd-or abandonod for six months.I hereby certify that I have read
this application and know the same to be true and conmet. All provisions of laws and ordinances governing this work will be complied with whether specified
or not. The perrait doce not give authority to viclato the provisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name - r-F Phone Number i33-jL-1L—
k-y- office Phonel'3:1 L 4 100 Fax
Mechanical Company
Co. Address: L41 JI City J—PC�4—StateeL zip sar�
"4 State Certification/Registration#
License Holder ((Pri t): V%�
i0t
Notarized Signature of License Holde
Sworn and subscribed before me this day of
Flow=i of
AO Put& FRWXW f Notary Publi
1X70. W"an R ignature o
MY mlewm F-Ei Ain$
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FEFIMMAED 09: 02 AM PAX No, P. 003
~ ww *1 CERTIFIED
Certificate of Product RatinEs
AFIRI Certified Reference Number- 3405589 Date: 2/17/2015
Product: Split System: Heat Pump with Remote Outdoor Unit-Air-Source
Outdoor Unit Model Number: 13PJL48
Indoor Unit Model Number: RHLL-HM4821+RCSL.H*4821
Manufacturer: RHEEM SALES COMPANY, INC.
Trade/Brand name: RHEEM; RUUD; WEATHERIKING
Series name:
Manufacturer responsible for the rating of this system combination is RHEEM SALES COMPANY, INC.
Rated as follows In accordance with AHRI Standard 210/240-2008 for Unitary Air-Conditioning and Air-Source
Heat Pump Equipment and subject to verification of rating accuracy by AHRI-sponsored, independent,third
party testing:
Cooling Capacity (Btuh): 44500
EER Rating (Cooling): 11.50
SEER Rating (Cooling): 14.00-% ,
Heating Capacity(BtUh)Q 47 FP 43500
Region IV HSPF Rating (Heating): 8.50
Heating Capacity(Btuh) @ 17 F: 25400
Ratings followed by an asterisk(*)indicate a voluntary rarate of previously published data,unless a=orripanled with.3 WAS.whic;h Indir0tes an involuntary rersts.
DISCLAIMER
AHM does not endorse the product($)listed an this certificate and makes no representations,warranties or guarantees as to,and assumes no responsibility for,
the pyoduct(s)listed on this Certificate.AHRI expressly disclaims all liability for damages of any kind arising out of the use or performance of the procilict(s),or the
unauthorized alterstlon of data listed on this Certificate.Certified ratings are voila only for models and configurations listed in the
directory at www.shridIrectery.org. Z211
TERMS AND CONDITIONS in, d
This Certificate and its contents are proprietary pirgdocts of ANRI.This Certificate shall only be used for individual,pertic.."i'n t
Purposes.The contents of this Certificate may not,in whole or in part,be reproduced;copied;dis mina ad; AM
confidential reference rwise utilized,in any form or manner or by any means,except Tor the user's individual, AIR-CONDITIONING,HEATING,
entered into a computer database:or othe
personal and confidential reference. &REFRIOERATION INSTITUTE
CERTIFICATE VERIFICATION this certificate can be verified at www-ah rid Irecto ry,o%,ClICk on 'Verify Certificate"link "mak�HF,�hvtter"
The lnformBtlon for the model cited on
end enter the AHRI Certified Reference Number and the date an which the certificate was Issued,
which is listed above,and the Certificate No.,which is listed at bottom right. FCEERTIFICATE NO.: 130686712852469488
@2014 Air-ConditioningT Heating, and Refrigeration Institute