1021 ATLANTIC BLVD MCHG PERMIT �S I 1J-
�3 CITY OF ATLANTIC BEACH
I 800 SEMINOLE ROAD
j � ATLANTIC BEACH,FL 32233
J
INSPECTION PHONE LINE 247-5814
MECHANICAL GAS PIPE PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5614
JOB INFORMATION:
Job ID: 16-MCHG-1302
Job Type: MECHANICAL GAS PIPING
Description: GAS PIPING UNIT 977-4 OUTLETS
Estimated Value: $1,850.00
Issue Date: 6/7/2016
Expiration Date: 12/4/2016
PROPERTY ADDRESS:
Address: 1021 ATLANTIC BLVD
RE Number: 177602-0040
PROPERTY OWNER:
Name: EQUITY ONE ATLANTIC VILLAGE,
Address: 16 NE MIAMI GARDENS DR ATTN: TREASURY DEPT
GENE RAL CONTRACTOR INFORMATION:
Name: PROGASCO, CORP.
Address: 7709 ALTON AVE
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: $69.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
MECHANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233 co -mCF(G - 1302
Ph(904)247-5826 Fax(904)247-5845
JoB ADDREss:_/0 2/ 4114 .iL ,BltJd I 7 PERMfT#
PROJECT VALUE$� 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
REQU/RED
Duct Systems: Total CFM
REPLACEMENT 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
FIRE PREVENTION t1 (Requires 3 sets of plans)
Fire Standpipe Q
Fire Sprinkler System 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 PIPIN% Heat Exchanger
Pumps
Quantity of Outlets -�7—_ Refrigerator Condenser BTU's
#Vented Wall Furnaces Solar Collection Systems
Water Heaters Tanks (gallons)
Wells
OTHER:
Permit biomes 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 author o violate the provisions/of any other state or local law regulation construction or the performance of constmction.
Property Owners Name S S O //E Phone Number
Mechanical Company U�A3� Office Phone 7Z S Fax7Z�d^7 7
Co.Address: 77Of 'd I70tj Au r- City �A�X—State�L Zip
License Holder(Print): F/✓n✓ h J P-/ 0 State Certifi 'on/Re 'Stratton#
Notarized Signature of License Holder
4)
/� 20- -
Ltefore me t_�.. day of u 1(.l9 P/
5 MY CtkAAtlSSIQVtFFm103B2 904 n.. r AA/,Qj
E�PIaIrS.May 14.M17 Signature of Notary Public
ATLANTIC BEACH
PERMIT RECEIPT
PERMIT DESCRIPTION:GAS PIPING-4 OUTLETS
PERMIT NUMBER: 16-MCHG-1302
ADDRESS: 1021 ATLANTIC BLVD
OWNER: EQUITY ONE ATLANTIC VILLAGE,
DATE ISSUED:
FEES DUE:
Gas Pipe Outlets $10.00
State Mech DBPR Surcharge $2.00
CITY OF ATAVT[C BEACH
State Mech DCA Surcharge $2.00 870 SENBNOLE RD
ATLANTIC BEAC,R.32233
06/07/2016 16:22:40
Trade Permit Base Fee $55.00 CREDIT CHAD
VISA SNF
CARD P MMN XXXXXXX1208
Totals: $69.00 INVOICE 0006
Q A: 0005
B6hh k: 000337
"Val Cade: 07166D
by Metlad: Mawal
NO& Online
Cad Code: M
SALE AMOUNT %9,00
CUSTOMER COPY