1107 Cornell Ln HVAC permitCITY 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
JOB INFORMATION:
Job ID:
16-MECH-2273
Job Type:
MECHANICAL HVAC ONLY
Description:
HVAC - 1 AC, 1 AHIJ, 2.5 TONS
Estimated Value:
$3,000.00
Issue Date:
10/11/2016
Expiration Date:
4/9/2017
PROPERTY ADDRESS:
Address:
1107 CORNELL LN
RE Number:
177387-4020
PROPERTY OWNER:
Name: CORTES ET AL, RAFAEL
Address: 1107 CORNELL ST 1107 CORNELL ST
GENERAL CONTRACTOR INFORMATION:
Name: MANCHENO A-C'Z SERVICES LLC
,CAC 1818324
Address: 4102 Joy LN
Phone:904-463-0919
PERMIT INFORMATION: Stidter 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 $20.00
State Mech DBPR Surcharge $2.00
State Mech DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $103.00
PERMIT LS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
RUILDUVG CODES.
J MECHANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph (904) 247-5826 Fax (904) 247-5845! ZZ 3 Lj o —(Y1 Fes.(-�•z Z%�J
JOB ADDRESS: /I07 OfNE%L CN fllCMI1( I3i'7i q r e PERMIT#
PROJECT VALUE $ OaJ ARI # r �/�j l ( 3 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 SY$TEM INSTALLATION
Air Conditioning: Unit Quantity Tons Per Unit a /Z
Heat: Unit Quantity —�— BTU's Per Unit Seer Rating
Duct Systems: Total CFM REQUIRED
FIRE PREVENTION
Fire Sprinkler System
Quantity
Fire Standpipe
Quantity
Underground Fire Main
Value
Fire Hose Cabinets
Quantity
Commercial Hoods
Quantity
Fire Suppression Systems
Quantity
FIRE PLACES
Prefabricated Fireplace Qty
Gas Piping Outlets
ALL OTHER GAS PIPING
Quantity of Outlets
# Vented Wall Furnaces
# Water Heaters
OTHER:
(Requires 3 sets of plans)
(Requires 3 sets of plans)
(Requires 3 sets of plans)
(Requires 3 sets of plans)
(Requires 3 sets of plans)
(Requires 3 sets of plans)
MISCELLANEOUS:
Automobile Lifts'
Boilers - BTU's.
Elevators/Escalators
Heat Exchanger
Pumps
Refrigerator Condenser BTU's
Solar Collection Systems
Tanks (gallons)
Wells
pem it becomes void it work does not commence within a six month period or work is suspended or abandoned for six months. r hereby cemty that i have read
this application and know the same to be tone 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 perfam Inge of construction.
Property Owners Name /AW -A Nd ji Q A•F E L Cd If 5 Phone Number 0 Z�
Mechanical Company IMAPffWO h1c 'i Pet, a 4cf4 bLC. OfficePhone r10-011 Fax
Co. Address: ((t L „�/ �-� l /1 City State � Zip 3 Z -)-Sl
License Holder (Print): RD'i? I Cr0 /)Tan)F'{i State-_Certifrcation/Registration # 0 / 2
Notarized Signature ojLieense Holder
Before me this
Signature of Notary Public
I/