1839 Seminole Mechanical Permit � `s f CITY OF ATLANTIC BEACH
;� A s) 800 SEMINOLE ROAD
j ` Z 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: 16 -MECH -1383
Job Type: MECHANICAL HVAC ONLY
Description: HVAC - 1AC, 1 AHU, 2.5 TON
Estimated Value: $4,200.00
Issue Date: 6/15/2016
Expiration Date: 12/12/2016
PROPERTY ADDRESS:
Address: 1839 SEMINOLE RD
RE Number: 169630 -0500
PROPERTY OWNER:
Name: RENNIE TRUST, JANICE BARKLEY
Address: 1839 SEMINOLE RD 1839 SEMINOLE RD
GENERAL CONTRACTOR INFORMATION:
Name: A/C MASTERS HVAC INC
Address: 11243 ST JOHNS PKWY APT 3 QA CHARLES STEVEN
CRABTREE
Phone: 904 - 722 -8995
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 $20.00
State Mech DBPR Surcharge $2.00
State Mech DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $103.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACII ORDINANCES AND THE FLORIDA
BUILDING CODES.
j CITY OF ATLANTIC BEACH
�. i L 7 800 SEMINOLE ROAD
'� � -r ATLANTIC BEACH, FL 32233
ATLANTIC BEACH N0P CTION PHONE LINE 247 -5814
r ° " 7 ' PERMIT RECEIPT
1 ti
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PERMIT DESCRIPTION: HVAC - 1AC, 1 AHU, 2.5 TON
PERMIT NUMBER: 16 -MECH -1383 PAID
ADDRESS: 1839 SEMINOLE RD JUN 15 2016
OWNER: CITY OF ATLANTIC BEACH
DATE ISSUED:
4- FEES DUE:
CC
Furnaces and Heating $24.00
CITY OF ATLANTI BEACH
AC and Refrigeration $20.00 800 SEMINOLE RD
ATLANTIC BEAC, C FL 32233 15:58:31
State Mech DBPR Surcharge $2.00 06;15/201
CREDIT CARD
VISA SALE
State Mech DCA Surcharge $2.00 XXkJ(XX XXX X7134
Card # 7
SEQ #: 150
Trade Permit Base Fee $55.00 Batch #: 7
INVOICE 050566
Approval Code'. Manual
Entry Method. Online
Totals: Mode $0.00
$103.00 Tax Amount: M
Card Code'.
SALE AMOUNT $103,00
CUSTOMER COPY
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND TI FLORIDA
BUILDING CODES.
FROM :A /C MASTERSHVAC,INC FAX NO. :9047228944 Jun. 15 2016 10:30AM P2
MECHANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH -
800 Seminole Rd Atlantic Bench, FL 32233
Ph (904) 247 -5826 Fax (904) 247 -5845 ) 6 - rn Ec H 1 33
Ins ADDRESS:
X139 1e vnT .
PROJECT VALUE
NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity - Tons Per Unit
Heat: Unit Q �tity , BTU's Per Unit _ Seer _
Duct Systems: Total REQUIR
,REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTAL -
Air Conditioning: Unit Quantity Tons Per Unit c2 • g ' Q r f' ��6 TI(
i 'b � D
, ._ Seer Rating_ 1 , � _
Heat: Unit Quantity ,1 BTU's Per Unit rt 0
Duct Systems: Total CF1M1 ._ _
FIRE PREVENTION ( 3 sets of plans)
Fire Sprinkler System Quantity >aires 3 sets of plans)
Fire Standpipe Quantity (Req
Underground Fire Main Value - (Req uires 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 woi k does not oonvncnce within a six month period or work is suspended or abandoned for six moods.1 hereby certify that 1 have read
this application and know the same to be true and correct. All provisions of laws and ordinances governing this work will be coined with whether specified
or not. The permit does not give ay to violate the proAlsions of any other state or local law regulation construction or the performance of construction.
Property Owners Name J c�v„7 e K (.n et ;- e Phone Number
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Mechanical Company Al C Kycrs / � /
ie e , Office Phone 1 7�) -`QfiJ� Fax -7 N
Co. Address: 4 L I S c a � �J : l i City Ja #?ni, s it c_.- State rt., Zip ,5 .1 r
License Balder (Print): _ e • •': I I a P r C is � ,. "_= s . e - + c 'cation/Registration # Ck i i) 3
Notarized Signature o License Holder ,►
: .'* : " : DSBRA ANN HOISINGTON Sworn and subscribed before m � � day of `t h L 20 -
MY COMMISSION tt EETI375 J / ` . I mr
.: }` ,:-' EXPIRES Or 15 2016 Signature of Notary Public �/_� 1�... z.�-� L�
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