121 PINE ST - HVAC f / '= Y , CITY OF ATLANTIC BEACH
,, >,,. .. l 800 SEMINOLE ROAD
c,
";N 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-707
Job Type: MECHANICAL HVAC ONLY
Description: 1 cu 1 ahu 2 TONS
Estimated Value:
Issue Date: 3/23/2016
Expiration Date: 9/19/2016
PROPERTY ADDRESS:
Address: 121 PINE ST
1 RE Number: 170636-0110
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:
Trade Permit Base Fee $55.00
State Mech DCA Surcharge $2.00
State Mech DBPR Surcharge $2.00
Furnaces and Heating $24.00
AC and Refrigeration $16.00
Total Payments: $99.00
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 (9904)247-5826 Fax (904) 247-5845
JOB ADDRESS: Jo?) 7y Slf �) A4VL ,3(` 13 PERMIT#
PROJECT VALUE $ L ARI# `f"SZo i REQUIRED
Air Handling Equipment Only GK 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
REQUIRED
Duct Systems: Total CFM
REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity Tons Per Unit c.? l
Heat: Unit Quantity 45 BTU's Per Unit )ct) Seer Rating (.Q
Duct Systems: Total CFM
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)
Wells
OTHER:
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'\ t S 54-cn-1-1-a t Phone Number q4 S oSSU
Mechanical Company A►i- b3,1I-‘2 S —;,P,.,34)(--5 t Crxo I� Office Phone PI -(, (3 Fax
Co. Address: I 30 r a -C Ofii x+ City-�a CIS vi(LQ Stated Zip .5 ac
License Holder Print • i dn�aiii. - State Certification/Registration#(A( (8)lp )Th
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. , • , ; • , ,I• q tai:e ,older ��/
Notary Public,state of Florida Before me this day o mar 20 1 b
° commission*FF 955577
My mom.expires Jan.28.2020 Signature of Notary Public