824 Sherry Dr mchg permit CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
MECHANICAL GAS PIPE PERMIT
MUST CALL BY 4PM FOR NE)Cr DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 17-MCHG-2912
Job Type: MECHANICAL GAS PIPING
Description: 6 gas piping outlets, 1 water heater, 120 underground
gallons, 1 tankless, I cooktop, I propane tank
EstimatedValue: $2,464.84
Issue Date: 114/2017
Expiration Date: 7/3/2017
PROPERTY ADDRESS:
Address: 824 SHERRY DR
RE Number: 170392-0000
PROPERTYOWNER:
Name: ANDERSON, TIMOTHY
Address: 824 SHERRY DR
GENERAL CONTRACTOR INFORMATION:
Name: FERRELLGAS L.P.
,00838
Addresu;: 922 9TH STREET S
Phone:
FEES:
Gas Pipe Outlets $12.00
State Mach DBPR Surcharge $2.00
State Mach DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $71.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITHI ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODE&
MECHANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, Fl,32233
Ph(904)247-5826 Fax(904)247-5945
oB ADDRESS: " a. 62641r. �3e,24 PERMrT# 17-90R6-c�W
PROJECT VALUE S--.2z6y. a
y ARI REQUIRED
.Air Handling Equipment Only _.Air Handling Unit& Condenser —Condenser Only
CEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity Tom Per Unit
Heat: Unit Quantity_ BTU's Per Unit Seer Rating
Duct Systems: Total CFM REQUIRED
tEPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity Tons Per Unit
Heat: Unit Quantity_ BTU's Per Unit—
Duct Systems: Total CFM — Seer Raung_
REQUIRED
PERE 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 (Req Uires 3 sets of plans)
Fire Suppression Systems Quantity (Requires 3 sets of plans)
MU PLACES MISCELLANEOUS:
Prefabricated Fireplace Qty Automobile Lifts
Gw Piping Outlets Boilers BTU's
Elevator��—mors
kLL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets .2 Pumps
#Vented Wall Furnaces Refrigerator Condenser TTU�s
# Water Heaters Solar Collection Systems
Tanks(gallons)
Wells
)THER: g!�-Qaa�
1.2o zzA
orma 1,ecoma�wild itwer1c does not cormence withat a six nth period or work vs suspended.1 mandated form months I hnr!r=�
ilsapplimtionudknow�c�elobe�cmdw�l. All provisions of laws and onfinames,governing this worl,will he complied with whether specified or
31. The permit does act give authority at violate,the prowsions ofany other state or local law regulation ,nastmetion or the performance ofoonmaton.
Yoperty0wriersNanne Phone Nuraber 22L- R,6,r-
Ucharlicall Company Office Phone ZK?7�Fox-hjLzej-29e
�o. Address: Rvoo j5-6' City ax4p )�,l State,�V- Zip 33;,&P-
,icense Holder(Print): S, #
lotarizedSignawreofLicemet.
Iftl NTHA J C N Before me this day of 0 I'l
of
Signature:of'Notary,Public
asta'seno... U
$ffFerre11qas PROPOSAL
Customer Name&Account#109619767 Tim Anderson Phone: (904)861-5122
Service Address: 824 Sherry Drive. Atlantic Beach 32233-5450
SALESPERSON JOB PAYMENT TERMS DUE DATE
S. Bertrand Install Tank and Lines Pas In Advance 01/29/2016
Scope of Work. Install PURCRASED 120UG=it use for Tank-lessis W/H(200,000)and Cook top
(70,000).Ran 1/-20 ft.of'/2"P.E.Piping exterior from new tank to W(H and Cook op. Hook Up
Resultants and correct System.Will need+/-3 hours W/two men for this intent].Permit Required W/City
OfAtlmtic Beach for this kiliv Locates needed as well.
Item Price Amount
1 purchase 120 Under Ground Tank $e92.70 ($118,30) $774.40
96 P M $240.78 iS48 96) $191.82
20 'A*R E. Pi i $140.00 ($5000) $90.00
1 10S eRe lator $86.99 ($20.99) $65.00
1 S eR lator S9D.99 ($15,99) $75.00
1 $48.99 (S28,99) $20.00
1 Burial Fee,and Anode $796.00 ($145�1)0) $050.00
1 le----i ea� $100.00 (1125100) $75-00
2X3 .1,,P—�T— $528.00 ($132,00) $3N.00 1
SUB-TOTAL $2MAS (64.99)
Plannift Fee Includin Prexceissi
State Sales Tax $218.57 (5,40.96) 1 $177.M 1
1 itletendedCushomarDiscemints 4$535,23)
1 Tobd Due I *246W I
Sign Approval of Proposal:
Credit approval or prepayment in fulil required upon scheduling of services.
Proposal is only valid for 30 days,and maybe voided if not accepted and sign within 30 days ofthis
rietacipt. Penrut Fees are nor-rctunclable.
All Work will be completed in accordance with all applicable laws, Femllgies' standard practices.and in a
workmanlike manner, Any changes in the above described job which requires additional equipment or
labor and results in additional cost will be performed upon receipt ofwiftcn orders from the customer,
Ferrellgas will not be Responsible for Dirt Removal on Underground Jobs,and ifremoved additional
charges may/will apply.
Ferrellgasi will not be responsible for clectricat/water/or bonding ofilaim
FemeftGait will not be iespoll for cabinet"distance eambenilenit,ver imees,and raianufa,ov
orp��adadons for aff klicken artollance inuaralladon.
Dependiaig oii Lhc oiundcipahl� that%ou reside in.the pernit %sill be pulled I unnarotiod"o he b"vmn 3
to6wee toneacquired NO JOBS will begin unlif the enria is approved and on location.
All Permitted Jobs mav reguipica propertySurvey/Aporajul to be submitted bi custome Failurelo
do so—wil..1v in d11-i-,u.P 'on star"ame ofi,".11arion,
INSTALLATION PROPOSAL - Attachment A
CUStomer Wn, Account N Date
A" FL zk�--
:Cat2m'l.i Ph I A�dd ,
Site Check Diagram
Appliance: ApplUmcs:
Cugornier SWmture --DM
FerreMas Signature