338 4TH ST GAS PIPE PERMIT rS \-1`l
I 3� �s, CITY OF ATLANTIC BEACH
f 800 SEMINOLE ROAD
J� ' ";� ATLANTIC BEACH, FL 32233
\ / r INSPECTION PHONE LINE 247-5814
MECHANICAL GAS PIPE PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-MCHG-1193
Job Type: MECHANICAL GAS PIPING
Description: GAS PIPING - 3 OUTLETS
Estimated Value: $995.00
Issue Date: 5/24/2016
Expiration Date: 11/20/2016
PROPERTY ADDRESS:
Address: 338 4TH ST
RE Number: 169818-0000
PROPERTY OWNER:
Name: STEELE, JAMES V
Address: 1874 BEACH AVE
GENERAL CONTRACTOR INFORMATION:
Name: CONSTRUCTION SOLUTIONS &
Address: QA NONE - UNABLE TO QA NONE - UNABLE TO FIND
Phone: - -
FEES:
Gas Pipe Outlets $10.00
State Mech DBPR Surcharge $2.00
State Mech DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $69.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
MECHANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904)247-5826 Fax (904) 247-5845 1 6„-p(c,k G -( 19 3
JOB ADDRESS: 338 4TH STREET PERMIT# �--
PROJECT VALUE$ 995.00 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 3_ 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: Install gas piping — 3 drops — ccok top, fireplace, grill
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 SH Design Phone Number 904-424-9652
Mechanical Company Construction Solutions & Supply LLC Office Phone 904-389-2700 Fax
Co. Address: 5225 Ed2ewood Ct City , ks- 'vile State FL Zip 32254
License Holder(Print): James P Romeka AA.", . Notary ! �00d8
State Certification/Registration# 1331244 / 42 ` t. Judy A Wilkerson
,/� � My Cwnmission FF 974414 i
Notarized Signature of License Holder LSI '�,. Ezores 05/0 oto
- - -
Before me this 1a ,' day of 20 \O