1823 Atlantic Beach Dr mchg permit CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
Z' INSPECTION PHONE LINE 247-5814
MECHANICAL GAS PIPE PERMIT
MUST CALL BY 4PM FOR NE]Cr DAY INSPECTION: 247-5814
JOBINFORMATION:
Job ID: 16-MCHG-2570
Job Type: MECHANICAL GAS PIPING
Description: install 4 gas-piping outlets
Estimated Value:
Issue Date: 11/15/2016
Expiration Date: 5/14/2017
PROPERTY ADDRESS:
Address: 1823 ATLANTIC BEACH DR
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: PERFORMANCE GAS SYSTEMS LLC
Jeffrey A.Harris, 15934
Address: 14775 EDWARDS CREEK RD
Phone:
FEES:
Gas Pipe Outlets $10.00
State Mech DBPR Surcharge $2.00
State Mech DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $69.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC REACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
Nov, 7, 2016 12:05PM No. 1806 P. I
MECHANICAL PERMIT APPLICATION
CITY OF ATLANTICHEACH
800 Seminole Rd Atlantic Boach, FL 32233
Ph(904)247-5826 Fax (904)247-5845 10-AAC (A 01- a SI-0
JoB Amms: A-q&a-, zej, Lv,).e PERWr 0 16 - 5 F-9-)0
PROJECT VAf UE$ — AAU# _REQUA 7J?ED
_,Ajr Handling Equipment Only __Air Handling Unit & Condenser _Condenser Only
NEW AIR CONDITIONING &HEATING SYSTEM INSTALLATION
Air Conditioning. Unit Quantity— Tons Per Unit
Heat: Unit(Mfity BTU's Per Unit Seer Ratinp.
Duct Systems: Total AE(?l7Dt9D
REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity Tons Per Unit
Heat: Unit Quantity BTU's Pet Unit Seer Rating
Duct Systems: Total CFM REQUIRED
NRE PREVENTION
Fire Sprinkler System Quani (Requires 3 sets of plans)
Fire Standpise ?umfity (Requires 3 sets of Plautus)
Un un Fire Main alue quires 3 sets of plans)
FiV"Hgolso Cabinets Quantity quires 3 sets of plans)
Commercial Hoods Quantity �equirea 3 sets of plans)
Fire Suppression Systems Quantity equires 3 sets of plans)
FIRE PLACES MISCELLANEOUS:
Prefabricated Fireplace Qty Automobile Lifts
Gas Piping Outlets 7iv Boilers BTU's
Elevators/Escalators
ALL OTHER GAS PIPINq Heat Exchanger
Quantity of Outlets !r Pumps
#Vented Wall Furnaces Refrigerator Condenser BTU's
#Water Heaters Solar Collection Systems
Tanks (gallons)
Wells
OTHER:
Permit becomes void if work does sent cornammoc�itlfln a six month period or worls is suspended or abandoned for six moraft I hereby certify that I have read
Lhis applicafing and know the same to be true and correct All provisions of laws and ordinances governing this vrvk will be complied with whether specified or
not The permit does not give authority to violate the provisions 0 my asto or too&]law reguastion construction OT the PM&�of Construction.
Prop,"Ownums Name f ricirc:V�& Phone Number
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N��;Fie'IlAde�(Print): ,)e;V- jjear,,�S State Certification/Registration# /.T4?3
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?�btdr4edft�ature ofLkense Holder ),, rr j L?OtL
TE-MFK=M I I B me this day o I A X ''VU
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Signature of Notary Public
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CTIN OF ATARC BEACH
BOO SEMBNOLE RD
ATL*nC BEAC,FL 32233 0959.4
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CITY OF RTLW IC BEACH
600 SEMINOLE ROAD
ATLANTIC BECK, FL 32233
PHONE (904) 247-5R26
Cashier Id; atibcld\atlbbja
Receipt Date: 11/15/2015 10:01:20 AM
Receipt Number: OS-71742
Job ID: 16-XIC-2570 - instal 1 4 gas-piping
outlets GI - Gas Piping Outlets $10.00
Job ID: lb-MrA-2570 - install 4 gas-piping
outlets MDBPR - State Mach DBPR Surcharge
$2.DD
Job ID: 16-WHG-2570 - install 4 gas-piping
outlets MDCA - State Mech BEA Surcharge
$2.00
J.1G ID: 16-MM-2570 - i nstall 4 ga.-p,-p,n
autlet. TP - Trade Permit Base Fee $55.8
0
Amount Due: $69.00
Tend, Information: Cash $69.00
Tender Type: CC
Tender A;n.nt: SG9.00
Change Due: $0.00