258 Pine St HVAC 2015 `S f CITY OF ATLANTIC BEACH
s) 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-920
Job Type: MECHANICAL HVAC ONLY
Description: RELOACTING DUCTS
Estimated Value:
Issue Date: 4/21/2015
Expiration Date: 10/18/2015
PROPERTY ADDRESS:
Address: 258 PINE ST
RE Number: 170553-0000
PROPERTY OWNER:
Name: DEL GALLOWAY, CHARLES
Address: 912 NW F ST APT 700
GENERAL CONTRACTOR INFORMATION:
Name: EMERGENCY HEATING AND AIR
Address: 5311 San Juan AVE
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:
Heat Exchanger or Coil in Ducts $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 (904) 247-5826 Fax (904) 247-5845
JOB ADDRESS: afs P1,4e 54o PERMIT #
PROJECT VALUE $ 3,CXXd' ARI# REQUIRED
Air Handling Equipment Only Air Handling Unit & Condenser Condenser Onlv
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 Solar Collection Systems
Tanks (gallons)
Wells
OTHER: Z4 llq l'q rc.0e (aZcx5) Pe Lrc, ,-41 6/ C-
'ermit 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
his 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
iot. The permit does not give authority to/violate the provisions of any other state or local law regulation construction or the performance of construction.
3roperty Owners Name 1wPhone Number
Aechanical Company Pf 2 �14c144�1Office Phone3�7�Fax
'o. Address: 53 l' xc 1 aClCt4 Ave— City d9-SGAWfff- Stater- Zip 36V/d
,icense Holder(Print)ZV.'11'G t _ Slate ertificatio egistration#CSG- l� .
Votarized Signature of License Holder
Before me this C�?- Vay o i 20�
z
Signature of Notary Public