2160 MAYPORT RD #805 - HVAC \ � 101'_t J\S, CITY OF ATLANTIC BEACH
-;,1\ 800 SEMINOLE ROAD
):, ATLANTIC BEACH, FL 32233
J� INSPECTION PHONE LINE 247-5814
MECHANICAL HVAC PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-MECH-1522
Job Type: MECHANICAL HVAC ONLY
Description: HVAC - 1 AC, 1 AHU, 2 TON #805
Estimated Value: $2,000.00
Issue Date: 7/5/2016
Expiration Date: 1/1/2017
PROPERTY ADDRESS:
Address: 2160 MAYPORT RD 0800
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: DAVID GRAY HEATING AND AIR INC
Address: 6491 S POWERS AVE RYAN C ZABINSKY
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:
Furnaces and Heating $24.00
AC and Refrigeration $16.00
State Mech DBPR Surcharge $2.00
State Mech DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $99.00
N
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 ( l.0 — 1 ► \E C-i- _I S Z Z
Ph(904) 247-5826 Fax (904) 247-5845
JOB ADDRESS: a l lop now!pc 47 1) A4 I An- l L? c11,3X 33 `1":-PERMIT#
PROJECT VALUE $ O O.00 ARI# 3t 3 I 55C, 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_ I Tons Per Unit 01
Heat: Unit Quantity I BTU's Per Unit ,00 0 Seer Rating 1 `f
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:
'ermit 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
lot. The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of construction.
'roperty Owners Name A kiu fYl q 4- a f I een-Ii L beacA Or Phone Number q01- a4I-5 73'7
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vlechanicalCompany a01 anal a1inn di- J OfficePhone`7a4-?aif Fax lai-i-5%25
-o. Address: (o LQ I -pc,l tJI(S l.(.Ut City \h C k,564 of)le State Fr__Zip ,baa/'7
..icense Holder(Print): ----RVCI n n(J i n 5 iCii 4 ` State Certification/Registration#44 )
Notarized Signature of License Holder f .3,{
Before me this --.54"—day of `�. 20 ) to
f-V
` Notary State of Florida 'n /� L'l M Mor
ales
Signature of Notary Public `�//V�/.-��T//
?oi i•on MyCommission FF 960643
Expires 02/15/2020