363 12th St HVAC permit 'rf y, Jrlri.,.
CITY OF ATLANTIC BEACH
_._ 800 SEMINOLE ROAD
u 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-2842
Job Type: MECHANICAL HVAC ONLY
Description: HVAC - 2 AC, 2 AHLI, TOTAL OF 10 TON (5 EACH)
Estimated Value:
Issue Date: 12/20/2016
Expiration Date: 6/18/2017
PROPERTY ADDRESS:
Address: 363 12TH ST
RE Number: 171917-0000
PROPERTY OWNER:
Name: Hand, Michael B
Address:
GENERAL CONTRACTOR INFORMATION:
Name: ENVIRONMENTAL A/C SERVICES,INC
,CAC057409
Address: 8110 CYPRESS PLAZA DR STE 106 CA HOWARD
KENNETH STALLS, JR
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 $28.00
AC and Refrigeration $80.00
State Mech DBPR Surcharge $2.00
State Mach DCA Surcharge $2.00
Trade Permit Base Fee $55.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
U ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDBVG CODES.
MECHANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233 //
-�/ Ph(904)247-5826 Fax(904)247-5845 1 l0 - MFC&( - Z84
JOB ADDRESS: `�3 544 PERMIT#
PROJECT VALUE $ ARI# REQUIRED
_Air Handling Equipment Only _Air Handling Unit& Condenser _Condenser Only
NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATLIO/N
Air Conditioning: Unit Quantity Tons Per Unit /vTQ-� ��
Heat: Unit Quantity BTU's Per Unit Seer Ratin d
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
Manual J documentation required on residential change out
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:
Pemdt 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 one 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 th rovismns of any other state or local law regulation construction or the performance of construction.
Property Owners Name A.47 S n / - Phone Number
Mechanical Company EPA,,j;ZW ++° j erLN4 Office Phone - V Fax
Co.Address: City T4 State Zip��-
License Holder(Print): S State Certification/Registration# 014-0571/4?1
Notarized Signature 9f License Holder
MY��� �PEgGER efore me this ay o
EXPIRES:Ocrosar S,2019
e�WR.K"Pi6bcUeM. . ignatureofNotary Public