2106 S FAIRWAY VILLAS LN - HVAC 17. .-
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CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
J ATLANTIC BEACH, FL 32233
\ N INSPECTION PHONE LINE 247-5814
MECHANICAL HVAC PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-MECH-929
Job Type: MECHANICAL HVAC ONLY
Description: 1 CU 1 AHU 2.5 TONS
Estimated Value: $3,600.00
Issue Date: 4/20/2016
Expiration Date: 10/17/2016
PROPERTY ADDRESS:
Address: 2106 S FAIRWAY VILLAS LN
RE Number: 169398-1030
PROPERTY OWNER:
Name: LEBEL, JUDITH
Address: 2106 S FAIRWAY VILLAS LN
GENERAL CONTRACTOR INFORMATION:
Name: SIMPLY AIR & HEATING INC
Address: 4104 Lenox AVE # 3
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:
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 $20.00
Total Payments: $103.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
MECHANICAL PERMIT APPLICATION
I CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904)247-5826 Fax (904)247-5845
Ln• (An JOB ADDRESS: 2t 0(, T O i 1 IA]Ay 'i I I A5 S L4{,) PERMIT#
PROTECT VALUE$ 3=c.oo. 0 0 AR/# `7 ni Q s 1 9 (p REQUIRED
Air Handling Equipment Only KAir 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 14
Duct Systems: Total CFM REQUIRED
REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity a,. Tons Per Unit 2,5
Heat: Unit Quantity I BTU's Per Unit .30,o 00 Seer Rating I LA
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)
Wells
OTHER:
'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
his 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
tot. The permit does not give authoo ity to violate the provisions of any other state or local law regulation construction or the performance of construction.
'roperty Owners Name t'1�tMR. At re-Lk gropthie 5 LLC Phone Number r l 40ql (01 gyp' 0(0 IPi-,
✓Iechanical Company %YI p 1,) A i 1Z Office PhonOrloY-7100 Fax 4c4 Z4 ?I aZ)
;o. Address: 410 4 L€v1n)( Ave S k. 3 City \A(ASo ylv;1k State CC_ Zip )-S14
aicense Holder(Print): ■ : F a State Certification/Registration# 1.s I b38 y
lotarized Signature of License Hold, 4 Mall, _
}04,9Y N, Notary Public State of Flori�efei e me this • d.: of el t• NNW 20 / 7.? - 2 6,4
Shirley L Graham
.c_. ��
y � My Commission FF 08699a�i ? ture of Notary Publ. � .•■ •
III
"40,,,,00 Expires 02/14/2018 �J g y _�— �