310 5TH ST 2016 HVAC r- Jai
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: 16-MECH-220
Job Type: MECHANICAL HVAC ONLY
Description: HVAC - 1 AC, 1 AHU, 3.5 TON
Estimated Value: $5,349.00
Issue Date: 1/28/2016
Expiration Date: 7/26/2016
PROPERTY ADDRESS:
Address: 310 5TH ST
RE Number: 169830-0000
PROPERTY OWNER:
Name: WILLEY, CLARK
Address: 310 5TH ST
GENERAL CONTRACTOR INFORMATION:
Name: CERTIFIED CLIMATE CONTROL LLC
Address: 3053 LAGOON AVE DAVID HILL
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 $28.00
State Mech DBPR Surcharge $2.00
State Mech DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $111.00
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) 247-582-6 Fax (904) 247-5845 I (a -rVA CP H- z-ZC)
OB ADDRESS: �J �� , IC PERMIT#
PROJECT VALUE $ S��'7 -/ ARI REQUIRED
_Air Handling Equipment Only 4Air Handling Unit & Condenser Condenser Only
4EW 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
MPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit QuantityTons Per Unit - 5
Heat: Unit Quantity�- BTU's Per Unit Seer Rating S
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
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
:)t. The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of construction.1
'roperty Owners Name Phone Number 4N a3
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•n�rpY p`Bl��i
r• •C: JODI DA SILVA efore me this da 20 _
. Notary Public•State o1 Florida
z �e My Comm.Expires Feb 14,2018
Commission#FF 63611 ignature of Notary Publ,
PERMIT AUTHORIZATION
be i ca�c�s ��Q1 fs
I, DAVID HILL hereby authorize : A �
(License Holder) (Authorized Person) r f
To obtain a permit in my behalf under my license # (.` l�(Q(Q3`-i
To the Atlantic Beach Building department for the
Job described below:
PERMIT TYPE DESCRIPTION
HVAC Owner Ola f
Site Address 0 S--t-l",
rj-)-I o r h L &aeh, a2 3aa33
Tax Parcel # h�
(License Holder Signature)
Date
State of Florida
County Of'Y!>Qy CJx
Affirmed and subscribed before me on this Z cv day of
20 t Co by DAVID HILL who is personally known to me.
C
*Notary
o Public,St e o orida Print,T Stamp Name of Notary
E398-0153
JODY L MCLEER
MY COMMISSION #FF039242
7111
EXPIRES July 24.2017
Florid allotaryservice.com