1871 ATLANTIC BEACH DR GAS PIPE PERMIT � �I y1.Ily
CITY OF ATLANTIC BEACH
J 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-1340
Job Type: MECHANICAL GAS PIPING
Description: GAS PIPING -4 OUTLETS
Estimated Value: $600.00
Issue Date: 6/13/2016
Expiration Date: 12/10/2016
PROPERTY ADDRESS:
Address: 1871 ATLANTIC BEACH DR
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: FIRST QUALITY GAS, INC.
Address: P O BOX 16303
Phone: - -
FEES:
Gas Pipe Outlets $10.00
Trade Permit Base Fee $55.00
State Mach DBPR Surcharge $2.00
State Mech DCA Surcharge $2.00
Total Payments: $69.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
MECHANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
1 Ph(904) 247-5826 Fax/(904)247-5845 l G-PA e.H(( - 3 4O
JOB ADDRESS: L S ! I �Q' /%' /fes b2 PERMIT#
PROJECT VALUE$ - " 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
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 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
DTHER:
'ertnit 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
mt. The permit does not give authority to violate the provisions ofany other state or local law regulation construction or the performance of construction.
'roperty Owners Name � IQrOP.✓f Phone Number
dechanicalCompany /!,%T z Pt, ;q�Office Phone Fax
;o.Address: P/9 Six 14303r City � State/ZZip,��
r- a
.icense Holder(Print): TK State Certification/Registration# 12 gi2,Z
iotarized Si
":_ MrTocon isslaysriFGE) Ore a this day Of
ia• FJ(PIRES:Oetahr0.20t9 20 /
r26r• Bvn°e1i""""'jPW` of Notary Public