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1588 Ocean Blvd - Pipe to Range and Grill (ri i.,4..fr''' t f CITY OF ATLANTIC BEACH r) 800 SEMINOLE ROAD ` � ' ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5814 N ff,, MECHANICAL GAS PIPE PERMIT MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247 -5814 JOB INFORMATION: Job ID: 15 -MCHG -2979 Job Type: MECHANICAL GAS PIPING Description: pipe to range andf grill Estimated Value: Issue Date: 1/29/2016 Expiration Date: 7/27/2016 PROPERTY ADDRESS: Address: 1588 OCEAN BLVD RE Number: 171886 -0000 PROPERTY OWNER: Name: FUSSELL, HALLIE L Address: 1588 OCEAN BLVD GENERAL CONTRACTOR INFORMATION: Name: AEI INTERNATIONAL CORP. Address: 7709 ALTON AVE QA LEWIS SPRADLIN Phone: - - FEES: Gas Pipe Outlets $30.00 State Mech DBPR Surcharge $2.00 State Mech DCA Surcharge $2.00 Trade Permit Base Fee $55.00 Total Payments: $89.00 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 — o — JOB ADDRESS: / g 8 tr 0 C e.4 r! R PERMIT # PROJECT VALUE $ 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 (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 Z' Pumps # Vented Wall Furnaces Refrigerator Condenser BTU's # Water Heaters ___ Solar Collection Systems Tanks (gallons) 1 2.0 Wells OTHER: / r e /^4 plj ( 46 i--; // (1 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 as,s ` Phone Mechanical Company a2/ .7/7/7 COir eiki 4 6: i, .SBra ecs Office Ph ne �2 l g 1 _2/ x 7 Co. Address: 9 9• Q /f de/a/7 i,, e City, Me krn / ✓ /sL State 7/ Zip 3 /, License Holder (Print): 8 e /,2 0. - p4, ✓AAA State Certification/Registration # 99/ 1 Notarized Signature of License Holder : _ ... _. , , 4 2 - ►,,, k Notary Public State a Florida Before me this 30 day of ,V CGCrn ht.- 20 / 5 p . Stephanie Renee McGuire ,C W ' �d' Expire 08/01/2017 033716 Signature of Notary Public • CITY OF ATLANTIC BEACH 800 SEMINOLE RD ATLANTIC BEAC, FL 32233 01,+29,'2016 15 :43:23 IT CARD CITY OF ATLANTIC BEACH CREDIT 800 SEMINOLE ROAD MC ATLANTIC FL 32233 Card # *0000000023785 Cashier (9 {904? R) 247 R7 - 5855 2 Cashier Id: aspcust \atlbbja B atch SEQ #: ; 52 Receipt Date: 1/29/2016 3 :45:57 PM Batch Receipt Number: OS-69085 INVOICE 02940P Job ID: 15 -MCHG - 2973 - pipe to range andf g A pproval Code: Manual rill G1 - Gas Piping Outlets $30.00 Enhy Method: � Job ID: 15 -MCHG - 2979 - pipe to range andf g Mode: Code. ; Online rill MDBPR - State Mech DBPR Surcharge $ Card 2.00 Job ID: 15 -MCHG - 2979 - pipe to range andf�g SALE AMOUNT $89.00 rill MDCA - State Mech DCA Surcharge $2. 00 Job ID: 15 -MCHG - 2979 - pipe to range andf g rill TP - Trade Permit Base Fee $55.00 CUSTOMER COPY Amount Due: $89.00 Tender Information: Cash $89.00 Tender Type: CC Tender Amount: $89.00 Change Due: $0.00