1201 Gladiola Street GAS PIPE PERMIT SS CITY OF ATLANTIC BEACH
r) 800 SEMINOLE ROAD
J ;", ATLANTIC BEACH,FL 32233
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-1336
Job Type: MECHANICAL GAS PIPING
Description: GAS PIPING
Estimated Value:
Issue Date: 6/10/2016
Expiration Date: 12/7/2016
PROPERTY ADDRESS:
Address: 1201 GLADIOLA ST
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: AA BOTTLED GAS COMPANY INC
Address: 12601 N MAIN ST EDDIE GENE THIGPEN
Phone: - -
FEES:
Gas Pipe Outlets $10.00
Trade Permit Base Fee $55.00
State Mech DBPR Surcharge $2.00
State Mech DCA Surcharge $2.00
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 I _ + v �C I I(.'_ '2j 3
JOB ADDRESS: la-101 Old �2e- PERMIT#L�`1
PROJECT VALUE $
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
ARI#
Air Conditioning: Unit Quantity Tons Per Unit REQUIRED
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 _ 0 Pumps
#Vented Wall Furnaces Refrigerator Condenser BTU's
# Water Heaters Solar Collection Systems
Tanks (gallons)
Wells
OTHER: b�, T c3C ,bG r �'� l e- - 5
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 provi ' of any other state or local law regulation construction or the performance of construction.
Property Owners Name Ko Phone Number
Mechanical Company Office Phk:n O-&ZS a."*75/-0&30
Co. Address: City 0ti/l A ,State Zip 327.15
License Holder(Print): State Certification/Registration# l3
Notarized Signature of License Holder
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Ca��� A.WATKI ature of Notary Public
=•: MY COMMISSION#EE83
g��� EXPIRES October
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tf.*7)398.0153 FloridallotaryS01"ce,com