296 ROYAL PALMS DR - MECH FIRE - ,:-�� :r
r
,�
�� _ '` �S, CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
; / r ATLANTIC BEACH, FL 32233
/ v INSPECTION PHONE LINE 247-5826
FIRE SUPPRESSION SYSTEM
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-MCHF-2527
Job Type: MECHANICAL FIRE PERMIT
Description: TAPAS AND WINE BAR
Estimated Value:
Issue Date: 10/26/2015
Expiration Date: 4/23/2016
PROPERTY ADDRESS:
Address: 296 ROYAL PALMS DR
RE Number: 177613-0000
PROPERTY OWNER:
Name: KLOTZ, JEFFREY DAVID
Address: P 0 BOX 330833
GENERAL CONTRACTOR INFORMATION:
Name: LIFE SAFETY DESIGNS INC
Address: 3038 LENOX AVE DARRYL ELKSNIS
Phone: - -
PERMIT INFORMATION:
FEES:
Trade Permit Base Fee $55.00
State Mech DBPR Surcharge $2.00
State Mech DCA Surcharge $2.00
Total Payments: $59.00
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
LL Ph(904)247-5826 Fax (904)247-5845
JOB ADDRESS: ca c'((;? £o'- ct\ ) l 4 PERMIT#
PROJECT VALUE $ 000 `6 ARI# REQUIRED
Air Handling Equipment Only Air Handling Unit & Condenser Condenser Only
—
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 l (Requires 3 sets of plans)
TIRE PLACES MISCELLANEOUS:
Prefabricated Fireplace Qty Automobile Lifts
Gas Piping Outlets Boilers BTU's
Elevators/Escalators
LLL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets Pumps
#Vented Wall Furnaces Refrigerator Condenser BTU's
# Water Heaters Solar Collection Systems
Tanks (gallons)
Wells
)THER:
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
its 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
at. The permit does not give authority to violate the ovisions of any other state or local law regulation construction or the performance of construction.
roperty Owners Name • �� �°tLN1 Phone Number)70 Ica
4echanical Company � e •' c? 1 J S\c g) O f f i c e Phon to
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`o. Address: 0(PD Le(\o)c Ak CR City-Tod-5.A tTolt Stated Zip S y
fr 004.7fDo) tole
,icense Holder(Print): e AnPU\ iA1 / State Certification/Registration#
Totarized Signature of License Holder /
Before me this .c> 4' of / fl0
Signature of Not. ..60, r
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