824 SHERRY DR - GAS PIPING (----
- +,s\J`1� �S, CITY OF ATLANTIC BEACH
f 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
J �/
INSPECTION PHONE LINE 247-5814
\Ji�l� r
MECHANICAL GAS PIPE PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-MCHG-1799
Job Type: MECHANICAL GAS PIPING
Description: install 3 gas piping outlets. water heater, 250 gallon tank
Estimated Value: $1,195.00
Issue Date: 8/8/2016
Expiration Date: 2/4/2017 _
PROPERTY ADDRESS:
Address: 824 SHERRY DR
RE Number: 170392-0000
PROPERTY OWNER:
Name: ANDERSON, TIMOTHY
Address: 824 SHERRY DR
GENERAL CONTRACTOR INFORMATION:
Name: FLORIDA PROPANE PARTNERS
Address: 461 TRESCA RD TIM CALLAHAN
Phone: - -
FEES:
Gas Pipe Outlets $10.00
Gas Piping Vented Units $5.00
State Mech DBPR Surcharge $2.00
State Mech DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Gas Piping Vented Units $5.00
Total Payments: $79.00
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
Ph(904)247-5826 Fax (904) 247-5845
JOB ADDRESS: (D)* SL.LCrL* Or• PERMIT# ib` Matel -
- 11-41C1
PROJECT VALUE $ ( (1 ~ ~S . 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) 3 J Q 6 I-.
Wells
OTHER:
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 the provisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name n SQ:[`c d (40n c S , Phone Number q(0L1 s`'s- 377
Mechanical Company P(or:ck` oe�nt Office Phone fis �4 P,1�\Fax 7,-`1.-1 a 1 a x-13
Q Citya:4361%0i.lit State-ft Zip 32 225
Co. Address: it 6 t ire vis, CL�
License Holder(Print): 1 A ' i C?..-i State Certification/Registration# 3 6
Notarized Signature of License Holder _4 . _
AF. TONl GINOLESPERGER Before met is ?" day o kiwi tr. ( 20
,7 L. ;. MY COMMISSION it FF 924951
r. EXPIRES:October 6,2019 Signature of NotaryPublic •� �`
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*11.1;;;.• Bonded Thu Notary Pic unc eeM g