604 TIMBER BRIDGE LN - MECH GAS Ir��`�\
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CITY OF ATLANTIC BEACH
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800 SEMINOLE ROAD
J '`" �" � �'" `; ATLANTIC BEACH, FL 32233
\ INSPECTION PHONE LINE 247-5826
MECHANICAL GAS PIPE PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-MCHG-2508
Job Type: MECHANICAL GAS PIPING
Description: 3 OUTLETS 1 WATER HEATER SUMMER KITCHEN
Estimated Value:
Issue Date: 10/23/2015
Expiration Date: 4/20/2016
PROPERTY ADDRESS:
Address: 604 TIMBER BRIDGE LN
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: CONSTRUCTION SOLUTIONS &
Address: QA NONE - UNABLE TO QA NONE - UNABLE TO FIND
Phone: - -
FEES:
Gas Pipe Outlets $10.00
State Mech DBPR Surcharge $2.00
State Mech DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $69.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACII ORDINANCES AND THE FLORIDA
BUILDING CODES.
I
MECHANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904) 247-5826 Fax (904)247-5845
JOB ADDRESS: 5.. 4.1-1.4,1 416. 3c�,-!, ftr. ��?33 PERMIT# I,$_,�'f q-15-o„2
PROJECT VALUE $ 170O. ARI# REQUIRED
_Air Handling Equipment Only Air Handling Unit & Condenser Condenser Only
—
•EW 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
tEPLACEMENT 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
IRE 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)
IRE PLACES MISCELLANEOUS:
Prefabricated Fireplace Qty Automobile Lifts
Gas Piping Outlets Boilers BTU's
Elevators/Escalators
ALL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets 3 Pumps
# Vented Wall Furnaces Refrigerator Condenser BTU's
# Water Heaters _� Solar Collection Systems
Tanks(gallons)
Wells
)THER: sF,>Ir P, .`N ((, ik r W f-
crmit 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
us 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
x. 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 Po IoGt J t,as0.4 Phone NumbergoY- _S-3 73
klechanical Company A,j-I-L1,,,6,7a S,L1-i ? vpir Office Ph V',9-2700 F2 113P-
to. Address: 5'2.2 5 �� ,WG,o/ Cm�,' City, �, ,, 1/. State FL Zip 3- S1
,icense Holder(Print): j State Certification/Registration#CRC/331.4�
lotarized Si:nature o i •4 • older ''
pot Nis Notary Public State or Florida -fore me this al day of
Judy A Wilkerson
a 0.01 E pire 05/02/20162698
Signature of Notary Publ.* _, A `, -
•