388 4TH ST - HVAC ‘x,A CITY OF ATLANTIC BEACH •
• v 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
MECHANICAL HVAC PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-MECH-1235
Job Type: MECHANICAL HVAC ONLY
Description: DUCT WORK RECONFIGURATION
Estimated Value: $1,800.00
Issue Date: 5/31/2016
Expiration Date: 11/27/2016
PROPERTY ADDRESS:
Address: 388 4TH ST
RE Number: 169826-0000
PROPERTY OWNER:
Name: MODICA, TAMELA A
Address: 388 4TH ST
GENERAL CONTRACTOR INFORMATION:
Name: NORTH FLORIDA AIR MANAGEMENT
Address: P 0 BOX 17186 DAVID WILLIAM BUTLER
Phone: - -
PERMIT INFORMATION: Sticker for overcurrent protection must be on A/C equipment prior to
inspection. Failure to comply will result in a failed inspection and reinspect fees. No
exceptions.
FEES:
State Mech DBPR Surcharge $2.00
State Mech DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Air Duct System $20.00
Total Payments: $79.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACII ORDINANCES AND THE FLORIDA
BUILDING CODES.
MECHANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233 i /
Ph(904)247-5826 Fax(904) 247-5845 I C� -fV u H- 1 Z3 5
JOB ADDRESS: 3535 y7-,,i - 7%2fT- PERMIT#
PROJECT VALUE$ / 0- °° 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
OTHER: / /'2,JC2/4e �-a1.4,/~.,(7 )----7,,-,"
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 theheprovisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name T/12 ��//l'AC� Phone Number 9,/-��'S'�l
yob
Mechanical Company /44 'A, ,1 i4 /72,9A/r91•<iy�✓T Office Phone P99-5-
,,Vo Fax
Co. Address: 14 /S /744 City, /e5o v'i ccl- State/2 Zip ,P27"5--
License
P27"SLicense Holder(Print): 27, Y/D 472C to Certification/Registration# O9CIs7/G 7G.2
Notarized Signature of License Holder
•�s�. DAY AH.WIWAMS Before me this 31 1 dayof N 20 IL
> .-1 MY COMMISSION i FF 211841
do EXPIRES:August 7,2019
'•'4.R;,,n Bonded Thru Notary Pub,c Undenrrtars Signature of Notary Public 4a.vr it (,--)
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