1671 BEACH AVE GAS PIPE PERMIT CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
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-1 283
Job Type: MECHANICAL GAS PIPING
Description: GAS PIPING - RANGE, WATER HEATER, GRILL, AND
FIREPLACE
Estimated Value:
Issue Date: 6/16/2016
Expiration Date: 12/13/2016
PROPERTY ADDRESS:
Address: 1671 BEACH AVE
RE Number: 169658-0000
PROPERTY OWNER:
Name: GAY TRUST, SHIRLEY W
Address: 1671 BEACH AVE
GENERAL CONTRACTOR INFORMATION:
Name: AEI INTERNATIONAL CORP
Address: 7709 ALTON AVE QA LEWIS SPRADLIN
Phone:
FEES:
Gas Pipe Outlets $10,00
Gas Piping Vented Units $10.00
State Mech DBPR Surcharge $2.00
State Mech DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $79.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
061'03/2016 01: 51 9047213350 AEIGAS PAGE 01,i0l.
MECHANICAL PERMIT APPLICATION
CYrY OF ATLANTIC BEACH
goo Seminole Rd Atlantic Beach, FL 32233
Ph(904) 247-5826 Fax (904)24.7-5845
(OBADD.RFSS: PERMff#
P AJU# REQUIRED
ROJECT VALUE
Air Handling Equipment Only Air Handling Unit & Condenser Condenser Onl)
NT-F,W AIR CONDITIONING & REATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity Tons Per Unit
Heat-, .Unit Quantity BTU's Per Unit Seer Ra, ' .REQUIRED
Duct Systems: Total CFM
ZEPLACEMEENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity Tons Per Unit Seer Ratin.
Heat: unit Quantity BTU S Per UUit REQ
Duct Systems: Total CFM
4RE PREVENTION (Requires 3 sets of Plans)
fire Sprinkler System Quantity
Fire Stand ' Quantity (Requires 3 sets of plans)
UndergroupalSeFire 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 Suppregsion Systems Quantity (Requires 3 sets of plans)
TIRE PLACES MISCELLANEOUS:
Prefabricated Fireplace Qty Automobile Lifts
Cias Piping 0aets Boilers 13TU's
Elevators/Escalators
�LL OTHER GAS P11"ING Heat Exchanger
Quantity of Outlets Pumps
4 Vented Wall Furnaces Refiigerator Condenser BTUs
# Water Heaters Solar Collection Systems
Tanks (giallons)
Wells
)TffER-. Dn,-� 00�n(� 'C jwcY�L hpalen 9�li -��tc
ji x mouth period or work is suspended or-abwdoned fbr:�Ix am&s.I hercby cort*thilt I havc,r
=it becomes void if work does not oorarnmoo wid n a si
lis application and know the same to be tr=and corro�t AJ1 provisions of laws and ordinano"governing this work will be complird with whether specifl
ot, The permit dw not give�4thoritY to violate the provisions of any other state or local law regulation construc;tion.or the pedommee of conmc;ti0n.
;ropert.y Owners Name jP --0-V —Phone
0o - :1��n Y-,/,)ro,- office Phone_�2"+'17 lFax
Aechanical Company EL rA�_ Cuo dion
vr) State 1-ZipS12- ,
Address:]ID2_ LA , city _E
,jeense Holder(Print): 5f lir)��io o( —State Certification/Registration 9 LL7
�()tartzed s�gnature of License Holder
N
%IPN of W's)La-
a) day
of Before me this
taryPubic$tate
Stephanie RenG ire
a MCGJ
ic
My Commimim F Signature of Notary Pubt
Expires 00101J2017
IF
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CITY OF ATLANTIC REACH
BOO SEMINOLE ROAD
IC
ATLANT IC REACH F�L 32133
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7
P�HONE (904! 24�-5859-
Cas,hier Id: atibcld\atlbcct
RLceipt Date: 6/16/2016 9:09:45 AM
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Receipt Number: 0� 701ulS
Job T D: 16-MCHG-1283 - GAS ING
WATER HEATER, GRILL, AND FT PIP RANGE,
Piping Outlets $10.00 IREPLACE G! - Gas
job ID: 16-MCHG-1283 - GAS PIPING RANGE,
WATER HEATER, GRILL, AND FJIREPLACE G3 - Gas
Piping Vented Units $10.00
Job ID: 16-MCHG-1283 - GAS PIPING - RANGE,
WATER HEATER, GRILL, AND 91REPLACE MDDPR -
State Mech DBPR Surcharge $2.00
Job ID: 16-MCHG-12B3 - GAS PIPING - RANGE,
WATER HEATERz GRILL, AND FIREPLACE MDCA - IS
tate Mech DCA Surcharge $2.00
Job 1D: 16-MCHG-!-,-,R-.l - GAS PIPING
I - RANGE
WATER HEATER, GRILL, AND FIREPLACE TP - Tr'a
de Permit Base Fee $55.00
Amount Due: $79.00
Tender T nform.ation: Cash $79.00
1
Tender Type: CC
Tender Amount: $79.00
Change Due: $0.00