1580 Beach Ave mchg permit CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
j � ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
MECHANICAL GAS PIPE PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
.Job ID: 16-MCHG-2729
Job Type: MECHANICAL GAS PIPING
Description: GAS PIPING - GAS RANGE
Estimated Value:
Issue Date: 12/7/2016
Expiration Date: 6/5/2017
PROPERTY ADDRESS:
Address: 1580 BEACH AVE
RE Number: 171875-0000
GENERAL CONTRACTOR INFORMATION:
Name: EXPERT GAS APPLIANCE SERV CO
12793
Address: P O BOX 338 ROBERT CARROLL
Phone: -
FEES:
Gas Pipe Outlets $10.00
State Mach DBPR Surcharge $2.00
State Mach DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $69.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
MECHANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233
Ph(904)247-5826 Fax(904)247-5845 0;"(a(N�
JOB ADDRESS: /ys'O j9LI3/-4 Ar/- PERMIT# /(o'RA/rI lt'."k/0.�
PROJECT VALUE$ SAY,oo ARI# REQUIRED
_Air Handling Equipment Only _Air Handling Unit& Condenser _Condenser Only
NEW 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
REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity Tons Per Unit
j Heat: Unit Quantity BTU's Per Unit Seer Rating
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)
Fre 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 I Pumps
#Vented Wall Furnaces Refrigerator Condenser BTU's_
# Water Heaters Solar Collection Systems
Tanks(gallons)
Wells
OTHER: —rXTe+ref AS L 'Ne 70 6(ekal /oCI4hdta-,
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 read
this application and knew the same to be true and comeel. All previsions of laws and ordinances governing this work will be complied with whether specified or
not. The permit does not give uurhority yr Isleetthe provisions of anyother steric al law regulation construction or the performance of censnuclion.
Property Owners Name Z �+ -D Phone Number
� � o
Mechanical Company ffice Phonf '�e'9�',Ca'Fax 79—y5d 2
Co.Address:_SN/SG City State F1AY-Zip 72aV
License Holder(Print): err /r State Certification/Registration# /2 763
Notarized Si nor der Li�a.��
n a:
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TNIGINeION#' Eft„_ urssloser9z a l eftte me this day of 20 E%PIPES:Odober6�2019 wnnvue¢ummmaa ignature ANotary Public_