336 10TH ST - GAS PIPING s:S1 -01°, `i, CITY OF ATLANTIC BEACH
A s 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
MECHANICAL GAS PIPE PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-MCHG-2002
Job Type: MECHANICAL GAS PIPING
Description: GAS PIPING - 3 OUTLETS AND WATER HEATER
Estimated Value:
Issue Date: 9/6/2016
Expiration Date: 3/5/2017
PROPERTY ADDRESS:
Address: 336 10TH ST
RE Number: 170037-0000
PROPERTY OWNER:
Name: BULL, KATHLEEN & NIELS, *
Address: 336 10TH ST
GENERAL CONTRACTOR INFORMATION:
Name: TUBE WORKS
, 17342
Address: 9652 CHUTNEY CT
Phone: - -
FEES:
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 Pipe Outlets $10.00
Total Payments: $74.00
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 i 6 -V &(�-ZOdZ--
JOB ADDRESS: 3-3 (o /0 7 -4 s7 PERMIT# G‘--5/5e'-73C.)
PROJECT VALUE $4/ ARI# REQUIRED
Q
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 0 Boilers BTU's
Elevators/Escalators
ALL OTHER GAS PIPIN Heat Exchanger
Quantity of Outlets �S Pumps
#Vented Wall Furnaces Refrigerator Condenser BTU's
#Water Heaters ___/_. Solar Collection Systems
Tanks (gallons)
Wells
OTHER: 1 4,51-6,_///25 jCs•.S •' �� / k vr5 P_ �`x41 lettiiPQc OA
'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
tot. 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 Phone umber
vlechanical Company ,> Z.
• Z - Office P one s` a Fax
)p,_
:o. Address: /?o'• 66 p( 3 ?//0.2 City StatbZip-3"2°22( ?lam
'icense Holder(Print): 2a,7 e. 4. _/e yq" :to ertification/Registration# d J5-c1 y
Votarized Signature of License Holder (. 11,41
GINDIESPERG.r.e or me this day o; • I �, A 21 6
r y h TONT I �= /
�� MY COMMISSION$FF 824951
{i" ' EXPIRES.October 6,1 a t e of Notary Public __, �,� �, ..�a
cnded Thor Notary Public U ere
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