377 1st St HVAC permit .fI
CITY OF ATLANTIC BEACH
r, 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-2302
Job Type: MECHANICAL HVAC ONLY
Description: replace 3.0-ton AHIJ
Estimated value: $3,000.00
Issue Date: 10/13/2016
Expiration Date: 4/11/2017
PROPERTY ADDRESS:
Address: 377 1ST ST
RE Number: 169774-0010
PROPERTY OWNER:
Name: TOMSON, WILLIAM &ANNE,
Address: 13057 S HIGHLAND GLEN WAY JACKSONVILLE, FL
GENERAL CONTRACTOR INFORMATION:
Name: ARCTIC AIR OF NE FLORIDA, LLC
Charlton Leon Parks,CAC057352
Address: P O BOX 50496 QA CHARLTON LEON PARKS
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 $20.00
AC and Refrigeration $24.00
State Mach DBPR Surcharge $2.00
State Mach DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $103.00
PERMIT IS APPROVED ONLY M 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 �b_ME�,1 - a300-
JOB ADDRESS: 7 7 / S T 54- n PERMIT#
PROJECT VALUES ARI# -7 44 I y b J 7 REQUIRED
_Air Handling Equipment Only ZAir Handling Unit & Condenser _Condenser Only
NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity Quantity Tons Per Unit --�
Heat: Unit uantit -o Seer Per Unit - Seer Rating
Duct Systems: Total CFM REQUIRED
REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit QuantityTons Per Unit 3
Heat: Unit Quantity� BTU's Per Unit�p-0 Seer Rating, /� f7
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 same to be true and correct All provisions of Taws 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 cons[mctim or the performance of construction.
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Property Owners Name I'L i y h A.0 I'J /;S �, i--,kc Phone Ntunber 7 f Z.' 1&-96 y
Mechanical Company 4 K-r^ J C- 4i/1 i//,,.1 (rm=q Z�N Office Phone 911105*i�t ax-
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Co. Address: City�n ,< State,Lzip3.z2J
License Holder(Print): /J State Certificati istration ot C o S 73 S5-2—
Notarized
2Notarized Sr nature of License Holder L-
.;" urc�aaisyogi nat Before me this l3f' day of OC.'(Ca3Q,� 20 l
.... '` amarnwrmE Dietl ruw.rr � J'�^
r..,l.• Signature of Notary Public \ a r