645 OCEAN BLVD HVAC PERMIT CITY OF ATLANTIC BEACH
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
IOB INFORMATION:
lob ID: 16-MECH-1830
lob Type: MECHANICAL HVAC ONLY
Description: HVAC - 2 AC, 2 AHU, 3.5 TON
Estimated Value: $7,400.00
Issue Date: 8/11/2016
Expiration Date: 2!7/2017
PROPERTY ADDRESS:
Address: 645 OCEAN BLVD
RE Number: 170126-0000
PROPERTY OWNER:
Name: LACKIE, RAYMOND R AUDREY,
Address: 1300 FLORIDA BLVD
GENERAL CONTRACTOR INFORMATION:
Name: R.G. WALLACE MECHANICAL
Address: 1905 RIVER OAKS DR OA ROGER GLENN WALLACE
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 $28.00
AC and Refrigeration $28.00
State Mech DBPR Surcharge $2.00
State Mech DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $115.00
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)247-58216 Fax (904)247-5845
37
JOB ADDRESS LIS OCca^ ��vd if�f o h� /f tQ 3 7. PERMIT#
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PROJECT VALUE s T ya O ARI# 2-o bn
(�O ( s -REQUIRED
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_Air Handling Equipment Only ?`Ai � g Unit & Con
Condenser Only
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NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION
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Air Conditioning: Unit Quantity 2 Tons Per Unit zn fan 4E Std'
Heat: Unit Quantity 2 BTU's Per Unit uoo Seer Rating
Duct Systems: Total CFM I.you z y, u 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 QtyAutomobile 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:
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 some 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 :3�v e Tn �Z�olo Phone Number
Mechanical Company kv� 6. i✓w//2c.- 11-f-A— s&1I Office Phone Mr-PSIZCFax
Co. Address: *' tf•1te � &"-e- Zoa� City 57 6
• ^ StatarL Zip32aQ-1-
License Holder(Print): cwt.
n..- IJUI State Certification/Registration# e^4'00700
Notarized Signature of Lice se Holder - 2 O E nX)a[[W 42
efore his 1—day o 20�
TtNIIGMOLEaPERGER
�jS3" uvcoMrmsslox OlFsml ignature of Notary Public
EXPIRES:Oclm"2019
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