509 CAMELIA ST - HVAC �" CITY OF ATLANTIC BEACH
, 1
I- r�: 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
N�� " 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-1744
Job Type: MECHANICAL HVAC ONLY
Description: 1 cu 1 ahu 2 tons
Estimated Value:
Issue Date: 7/21/2015
Expiration Date: 1/17/2016
PROPERTY ADDRESS:
Address: 509 CAMELIA ST
RE Number: 170899-0800
PROPERTY OWNER:
Name: MCKENZIE, DARRELL J
Address: 509 CAMELIA ST
GENERAL CONTRACTOR INFORMATION:
Name: A/C SYSTEMS OF JACKSON VILLEINC
Address: P 0 BOX 10236 QA PAUL GREGORY KINSER
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:
Furnaces and Heating $20.00
AC and Refrigeration $16.00
State Mech DBPR Surcharge $2.00
State Mech DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $95.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
MECHANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph (904)247-5826 Fax (904) 247-5845
JOB ADDRESS: cibq C 0„yip 1 SLr e eb • PERMIT#
en _
PROJECT VALUE$ ye-2.3 2 r ARI# S S-4 2 a 7 REQUIRED
Air Handling Equipment Only 4Air Handling Unit & Condenser Condenser Only
NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity I Tons Per Unit o9
Heat: Unit Quantity I BTU's Per Unit Del•D Seer Rating i y
Duct Systems: Total CFM REQUIRED
REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity 1 Tons Per Unit Z._
Heat: Unit Quantity I BTU's Per Unit Seer Rating 13
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:
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 .nn a;,n S bra l— ( Phone Number 4C1- to l4 -N 0--]9
Mechanical Company I j C c H s f o A r N s Off' loahstv, f P Office Phone Qri-1 Fax
434 a
Co. Address: n-ti+n hal l ()LIP . City n K4 no r t t e State (1 Zip 3 Z1_D"7-
License Holder(Print): ': • t • a o St. - Certification/Registration# t l e t.3_a33
Notarized Signature of License Holder `i% /�
if"; w . .
Before me this, day of 20 X_
•; MY COMMISSION#FF081544 Signature of Notary Pubnc ,_p „ {_
EXPIRES January 8.2018
(407)398.0153 Floridallotaryservice.com