258 PINE ST - HVAC CITY OF ATLANTIC 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-1389
Job Type: MECHANICAL HVAC ONLY
Description: 3.5 TONS 42k BTUS
Estimated Value:
Issue Date:
Expiration Date:
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: -
FEES:
Furnaces and Heating $20.00
AC and Refrigeration $28.00
State Mech DBPR Surcharge $2.00
State Mech DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $107.00
PERMU IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
MECHANICAL PERMIT APPLICATION /Zr\
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
/� Ph(904)247-5826 Fax(904)247-5845
Jon ADDRESS: o(,✓ O
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` 41f PERMIT# iE AICA-11aO
PROJECT VALUE $ 3 — ARIGREQUIRED
_Air Handling Equipment Only _Air Handling ilSi#�� �& Cot(dJuser _Condenser Only
NEW AIR CONDITIONING & HEATING SYSTEM INS, A
Air Conditioning: Unit Quantity Tons Per Unit
Heat: Unit Quantity BTU's Per Unit Seer Rating
Duct Systems: Total CFM R D
REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity I Tons Per Unit '33l
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 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)
//��
^t Wells
OTHER R,e 1,f cGf,yq Ay- *V 44+f/C -
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 time and concoct. 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 army other some or local law regulation concoction or the performance of construction.
Property Owners Name 11OW e Phone Number
Mechanical Company �if-EM�Vr� ^iXi 4x/ �� Office Phones �t ax
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Co.Address: CityXAd� --zoa/r State -Zip -- 714
License Holder(Print):Ge/.r��1'GM S e Certification/Registration#5;� t-/tSl �.
Notarized Signature of License Holder M
MI
p fo me this 1__`day o \1 Ll�ti(, 20
BpU.�+gRa ure of Notary Public X14 14!� �
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