184 Sylvan HVAC 2015 11 SS CITY OF ATLANTIC BEACH
J 800 SEMINOLE ROAD
X ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
MECHANICAL HVAC PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
]OB INFORMATION:
Job ID: 15-MECH-367
Job Type: MECHANICAL HVAC ONLY
Description: 2.5 TONS, 30k BTUS
Estimated Value:
Issue Date: 2/19/2015
Expiration Date: 8/18/2015
PROPERTY ADDRESS:
Address: 184 SYLVAN DR
RE Number: 170644-0000
PROPERTY OWNER:
Name: MYLOD, DONNA J
Address: 184 SYLVAN DR
GENERAL CONTRACTOR INFORMATION:
Name: AIR SOURCE AMERICA INC
Address: 2615 CRYSTAL COVE CT RICHARD E EPPERSON JR
Phone: 904-233-8831
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 $20.00
State Mech DBPR Surcharge $2.00
State Mech DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $99.00
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: PERMIT#
PROJECT VALUE $4508.00 ARI# 7558152
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 1 Tons Per Unit 2.5
Heat: Unit Quantity 1 BTU's Per Unit 30,000_ Seer Rating 15
Duct Systems: Total CFM
FIRE PREVENTION (Requires 3 sets of plans)
Fire Sprinkler System Quantity (Requires 3 sets of plans)
Fire Standpipe Quantity (Requires
3 sets of plans)
Underground Fire Main Value (Requires
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 DONNA MYLOD Phone Number 904-249-3243
Mechanical Company AIR SOURCE AMERICA Office Phone 904-233-8831 _Fax 904-372-9379_
Ci JAX BEACH State FL Zip 32250
Co. Address: 207 20th St N h'
License Holder(Print): JASON BUE R State Certification/Registration# CAC 1816716
Notarizicense Holde
,+&%NOTARYPLUX Before me this day o 20\-—
STATE OF FLORIDA
C0w*FFi29M Signature of No li
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