240 SEMINOLE RD 2015 HVAC S, 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 INFORMATION:
Job ID: 15-MECH-432
Job Type: MECHANICAL HVAC ONLY
Description: 3TONS 36K BTUS
Estimated Value:
Issue Date: 2/27/2015
Expiration Date: 8/26/2015
PROPERTY ADDRESS:
Address: 240 SEMINOLE RD
RE Number: 170515-0000
PROPERTY OWNER:
Name: PARKER, RICKEY T.,
Address: 240 SEMINOLE RD
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 $24.00
State Mech DBPR Surcharge $2.00
State Mech DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $103.00
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: a PERMIT#
PROJECT VALUE $ U 5S—e ARI# `1 '%`1 %�.o\Z REQUIRED
Air Handling Equipment Only Air Handling Unit & Condenser Condenser Only
NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity Tons Per Unit
BTU's Per Unit Seer Rating
Heat: Unit Quantity REQUIRED
Duct Systems: Total CFM
REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity I Tons Per Unit
Heat: Unit Quantity 1 BTU's Per Unit �� Seer Rating
Duct Systems: Total CFM REQUIRED
FIRE PREVENTION (Requires 3 sets of plans)
Fire Sprinkler System Quantity Raequires 3 sets of plans)
Fire Standpipe Quantity (Req
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 QtyAutomobile 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 55\-�3'��
Mechanical Company ��y Sa�r A"" u Office Phonaba.- 31 Fax �`�=�►���
State
Co. Address: Zip3»c v
License Holder(Print): —\I •-��^��`�''�^ State Certification/Registration#
Notarized SignaWkVp nse Holde &�Z
NOTARY Be me this �-�• y of 20--�---
STATE OF FI.ORMA
canrN M29e Signature of Notary Pub
EVIm 6/4/2018