800 Seminole Rd HVAC permit ?S lir c�
CITY OF ATLANTIC BEACH
r j 800 SEMINOLE ROAD
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-2865
Job Type: MECHANICAL HVAC ONLY
Description: HVAC - 1 AC, 1.5 TON
Estimated Value: $2,200.00
Issue Date: 12/27/2016
Expiration Date: 6/25/2017
PROPERTY ADDRESS:
Address: 800 SEMINOLE RD
RE Number: -
GENERAL CONTRACTOR INFORMATION:
Name: NORTHEAST FLORIDA HEAT &AIR
,CMC044837
Address: P O BOX 60533 QA JOHN FORREST WADE, III
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:
AC and Refrigeration $12.00
State Mech DBPR Surcharge $2.00
State Mech DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $71.00
111(10111' IS APPROVED ONLY W ACCORDANCE WITH ALL CITY OF ATLANTIC REACH ORDINANCES AND THE FLORIDA
BLIIDING CODE&
MECHANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233 / c
Ph(904) 247-5826 Fax (904)247-5845 (p _ mE✓C-0 —z c(�
Jos ADDRESS: � C.�2 ,nAe `\� c� PERMrr#
PROJECT VALUE$ ��CO ARI# (7cII���� REQUIRED
_Air Handling Equipment Only _Air Handling Unit& Condenser ZCondenser 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
Au Conditioning: Unit Quantity Tons Per Unit B
Q tY� ���,,
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)
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 Qty Automobile 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:
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 I have read
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 auat�\on`ty to viol\ate``the Ecovisions of any other slate or local law regulation construction or the performance of construction.
Property Owners Name \'Lt\O't�'t\L\�2�.LV� Phone Number
q0li
Mechanical Company \ \C cVsA � k Office Phone�_`
Co. Address: 7-K Qertre coo S City -3� StateV Z
License Holder(Print): �.. nttt State Certification/Registration#
Not='4"'44-DEBRA
' ense Holder
FfNSINGA Beforem this��dayof dr 20 (b
loxlvellnnep[a3.]Il1H
Signature of Notary Public ti