1105 Hibiscus St - Mech HVAC Only f _ t* j !.r\.J
s� � CITY OF ATLANTIC BEACH
�� 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
_ 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 -2971
Job Type: MECHANICAL HVAC ONLY
Description: HVAC - 1 AC, 1 AHU, 2 TON
Estimated Value: $3,850.00
Issue Date: 1/12/2016
Expiration Date: 7/10/2016
PROPERTY ADDRESS:
Address: 1105 HIBISCUS ST
RE Number: 171011 -0090
PROPERTY OWNER:
Name: SILVERMAN,MICHAEL J & JULIANNA, *
Address: 4288 W RUBY DR
GENERAL CONTRACTOR INFORMATION:
Name: AIR MCCALL INC
Address: 6662 S COLUMBIA PARK DR QA DAVID ALAN SALTER
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 $24.00
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: $99.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
12- 30- 15;15:12 ;From: To:2475845 ;9042886619 # 1i 1
MECHANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph (904) 247 -5826 Fax (904) 247 -5845 1 - l\.&EQ 4-{ - Zci 7 I
JOB ADDRESS: _1105 HIBISCUS ST PERMIT #
PROJECT VALUE $3850.00 ARI # 7489174 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 1 Tons Per Unit 2
Heat: Unit Quantity 1 _ BTU's Per Unit 5KW _ Seer Rating 14
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)
Welts
OTHER:
mer■►
Permit becomes void if work does not commence within a six -month period or work is suspended or abandoned for six months. 1 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 MIKE SILVERMAN Phone Number 904 -316 -4777
Mechanical Company AIR MCCALL Office Phone 904 -288 -6110 Fax 904- 288 -6619
Co. Address: 6662 -1 COLUMBIA PARK DR S City JACKSONVILLE State FL Zip 32258,
License Holder (Print): JONATHAN J M C • N - State Certification/Registration # CMC1249941
Notari , ig�� Holder � / ' /,,
_ � � r ti/
' 1 day EMBED 2015
• 5u itOFFun A Be f. m s 18 da • D
" , , Commit FF —
¢ Signature of Notary Publicl• _ 3
CITY OF ATLANTIC BEACH
800 SEfMINOLE ROAD
ATLANTIC: BEACH, FL 32233
PHONE (904) 247 -5855
Cashier id: aspcust \atibbja
Receipt Date: 1/12/2016 8:34:45 Aft
Receipt Number: 0S -68954
Job ID: 15-MECH-2971 - HVAC - 1 AC, 1 AHU,
2 TON MI8 - Furnaces and Heating $24.00
Job ID: 15 -(TECH -2971 - HVAC - 1 AC, 1 AHU,
2 TON M2 - AC and Refrigeration $16.00
Job ID: 15 -MECH -2971 - HVAC _ 1 AC, 1 AHU,
2 TON MDBPR - State Mech DBPR Surcharge $
2.00
Job ID: 15 -MECH -2971 - HVAC - 1 AC, 1 AHU,
2 TON f'IDCA - State Mech DCA Surcharge $2.
00
Job ID: 15 -MECH -2971 - HVAC - 1 AC, 1 AHU,
2 TON TP - Trade Permit Base Fee $55.00
Amount Due: $99.00
Tender Information: Cash $99.00
Tender Type: CC
Tender Amount: $99.00
Change Due: $0.00