420 Beach Ave HVAC permit �S II�'r
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CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
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MECHANICAL HVAC PERMIT
MUST CALL BY 4PM FOR NE)lT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-MECH-2603
Job Type: MECHANICAL HVAC ONLY
Description: replace 1.5-tan 18K-BTU AHU
Estimated Value: $3,250.00
Issue Date: 11/18/2016
Expiration Date: 5/17/2017
PROPERTY ADDRESS:
Address: 420 BEACH AVE
RE Number: 170163-0000
PROPERTY OWNER:
Name: KOERNER TRUST, BEVERLY
Address: 420 BEACH AVE
GENERAL CONTRACTOR INFORMATION:
Name: ISLAND HEATING AND AC
,CAC1817609
Address: 751 CAVALLA RD RONALD WAYNE LEE
Phone: -
PERMIT INFORMATION: Sticker for overcument 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:
AC and Refrigeration $12.00
Furnaces and Heating $20.00
State Mech DBPR Surcharge $2.00
State Mech DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $91.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
800 Seminole Rd Atlantic Beach,FL 32233
Ph(904)247-5826 Fax(904)247-5845
ME C tk-aao3
JOB ADDRESS: `�o(O Vac c(2 AV E PERMIT#
PROJECT VALUES . e2 5 0 ARI# S 33 19 1 5 REQUIRED
_Air Handling Equi
epment Only ✓Handling I uit& Condenser _Condenser Only
NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Aa 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 1 Tons Per Unit 1- 5-
Heat: Unit Quantity / BTU's Per Unit� Seer /Rating G
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(gallom)
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 1 have reed
this 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
not. The permit does not give authority to violate the provisions ofm y other state or local law regulation construction or the perfommnce of construction.
PropertyOwners Name -,56e Aetn.r Phone Number 9�Y-G(1-BoSsb
Mechanical Company (G,.a/11kd 09,0- Z,,- Office Phone.33?'G 7Yi Fax
Co.Address: IIL& Aannle� Coat♦- CityAi"4-. State R- ZAP 3a.26 �
License Holder(Print): /Ji t h._.,.t RN=a r!ZState 'on/Registration# r t T l-7(a o9
Notarized Signature of License Holder
fore me this 11 4k day of KW 20 iy
y.;ucw; t HEATHERaANIELLEBURREII
9rA MY COMMISSWNRFf91T570 gnatu ".f Notary Public
EXPIRES:APO 11,2020
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