1178 OCEAN BLVD MECH GAS PIPINGCITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
MECHANICAL GAS PIPE PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID:
15-MCHG-1240
Job Type:
MECHANICAL GAS PIPING
Description:
GAS PIPING AND 120 GAL TANK
Estimated Value:
Issue Date:
5/27/2015
Expiration Date:
11/23/2015
PROPERTY ADDRESS:
Address:
1178 OCEAN BLVD
RE Number:
170288-0000
PROPERTY OWNER:
Name: ROGERS ET AL, NICHOLAS W
Address: 1178 OCEAN BLVD 1178 OCEAN BLVD
FEES:
Gas Pipe Outlets $10.00
State Mach DBPR Surcharge $2.00
State Mach 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�� tali
Ph (904) 247-5826 Fax (904) 247-5845
JOB ADDRESS: W18 tri, r, 6mck PERWr #
PROJECT VALUE
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 At HEATING SYSTEM INSTALLATION
ARI#
Air Conditioning: Unit Quantity Tons Per Unit REQUIRED
Heat:_ Unit Quantity BTU's Per Unit Seer Rating
Duct Systems: Total CFM REQUIRED
FIRE PREVENTION
Fire Sprinkler System
Quantity
Fire Standpipe
Quantity
Underground Fire Main
Value
Fire Hose Cabinets
Quantity
Commercial Hoods
Quantity
Fire Suppression Systems
Quantity
FIRE PLACES
Prefabricated Fireplace'Qty
Gas Piping Outlets
ALL OTHER GAS PIPING
Quantity of Outlets —:2
# Vented Wall Furnaces
#Water Heaters _ I
r970-1711
.(Requires 3 sets of plans)
(Requires 3 sets of plaus)
(Requires 3 sets of plans)
(Requires 3 sets of plans)
(Requires 3 sets of plans)
(Requires 3 sets of plans)
MISCELLANEOUS:
Automobile Lifts
Boilers BTU's
Elevators/Escalators
Heat Exchanger
Pumps
Refrigerator Condenser BTU's
Solar Collection Systems
Tanks (gallons) rxO
Wells
Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for sue months. I hereby certify that I have rea3
,his application and know the same m be true and corral All provisions of laws and ordinances governing this work will be complied with whether specific
or not. Ile permit does trot give authority to violate the provisions ofany other state or local law regulation construction mthe performance of construction.
Property Owners Name1 "� Phone Number
/,..
Mechanical Company 1,1.e ,11;1711164e al� �o: CasJt1V,etrOffice Phone19�3iFax.2
Co. Address: ?9L 9' 41for z//V.0, CityA4<rPA1�//` State,�Zip 32-7
License Holder (Print): -ie �i�al a�/.., State Certification/Registration # g9/.; _
Notarized Si nature ofLuense Holder 1
at'=MIIEwornandsubscribedbeforemethis y of 201 4mEVIRESigutature of Notary Public