42 11 TH ST - GAS PIPING Liv y-
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CITY OF ATLANTIC BEACH
0 800 SEMINOLE ROAD
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Di ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
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MECHANICAL GAS PIPE PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-MCHG-1788
Job Type: MECHANICAL GAS PIPING
Description: GAS PIPING - 5 OUTLETS & 2 WATER HEATERS
Estimated Value:
Issue Date: 8/5/2016
Expiration Date: 2/1/2017
PROPERTY ADDRESS:
Address: 42 11TH ST
RE Number: 170269-0000
PROPERTY OWNER:
Name: TUCKER TRUST, ADELAIDE R
Address: 42 11TH ST
GENERAL CONTRACTOR INFORMATION:
Name: FLORIDA PROPANE PARTNERS
Address: 461 TRESCA RD TIM CALLAHAN
Phone: - -
FEES:
Gas Pipe Outlets $12.00
Gas Piping Vented Units $10.00
Trade Permit Base Fee $55.00
State Mech DBPR Surcharge $2.00
State Mech DCA Surcharge $2.00
Total Payments: $81.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL (Tfl OF ATLANTIC 13EAC11 ORDINANCES AND TIIE FLORIDA
RUILDINC CODES.
MECHANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233 PAC;/ --
Ph(904)247-5826 Fax (904)247-5845 i Cts &( G / 788
JOB ADDRESS: l) ) l[lin . 791-tomo? 6 r c - PERMIT#
PROJECT VALUE $ A RI # 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 a Solar Collection Systems
Tanks (gallons) . as--. (.1_ U(5
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 i Q C(a \ribr-i e 5 Phone Number goy 5-'L./s $`(7)
Mechanical Company E,c r;Ac, &et qe e c FA(0 Office Phone qvy 73y to 3 Fax 9.o4 731 a )
Co. Address: 4 C < -lasts 4 . City IRS/Amt(C State-ft Zip32ez S
License Holder(Print): (t(c,, xeo&<'cc�f 7 , _ 4 State Certification/Registration# 3 I a0c,
Notarized Signature of License Holder (�
ii =y.; TONT GINIXESPERGER ik
;, fore me th' day eir fi� 20 ( ,G
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,a, MY COMMISSION II FF 924951
'=_f EXPIRES:October 6,2019 V. ,r
--.:.„,--R, ' Bonded Thru Notary Pubic Underwriters 1 gnature of Notary Publics _