1728 MARITIME OAK DR - HVAC .>S 'vif
,( ,--41k, T, CITY OF ATLANTIC BEACH
,, 1`,v,,,. .:;,.-,; 800 SEMINOLE ROAD
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ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
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MECHANICAL HVAC PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 17-MECH-2982
Job Type: MECHANICAL HVAC ONLY
Description: install one (1) 5-ton 60K-BTU AHU
Estimated Value: $8,450.00
Issue Date: 1/17/2017
Expiration Date: 7/16/2017
PROPERTY ADDRESS:
Address: 1728 MARITIME OAK DR
RE Number: None
PROPERTY OWNER:
Name: RIVERSIDE HOMES OF N FL
Address: 414 OLD HARD RD STE 502 MATTHEW ROBERTS
GENERAL CONTRACTOR INFORMATION:
Name: A/C MASTERS HVAC INC
Charles Steven Crabtree, CAC1813854
Address: 11243 ST JOHNS PKWY APT 3 QA CHARLES STEVEN
CRABTREE
Phone: 904-722-8995
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 $40.00
Furnaces and Heating $20.00
State Mech DBPR Surcharge $2.00
State Mech DCA Surcharge $2.00
Trade Permit Base Fee $55.00
PERMIT IS APPROVED ONLY IN ACCORDANCE Willi ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
rA ` \ `SS CITY OF ATLANTIC BEACH
�1 s) 800 SEMINOLE ROAD
tOr - ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
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Total Payments: $119.00
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
PHONE (904) 247-5826
Cashier Id: atlbcld\atlbbja
Receipt Date: 1/17/2017 8:29:07 AM CITY OF ATLANTIC BEACH
Receipt Number: 0S-72183 800SEMINOLERD
Job ID: 17-MECH-2982 - install one (1) 5-to ATLANTIC BEAC,Ft.32233
n 60K-BTU AHU M2 - AC and Refrigeration $ 01'172017 08:29:06
40.00 CREDIT CARD
Job ID: 17-MECH-2982 - install one (1) 5-to
n 60K-BTU AHU M18 - Furnaces and Heating MC SALE
$20.00 Card>; XXXXXV000 X8768
Job ID: 17-MECH-2982 - install one (1) 5-to SEQ C 2
n 60K-BTU AHU MDBPR - State Mech DEPR Surch Batch#: 281
arge $2.00 INVOICE 4
Job ID: 17-MECH-2982 - install one (1) 5-to Approval Code: 152090
n 60K-BTU AHU MDCA - State Mech DCA Surchar Entry Method: Manual
ge $2.00 MOde:
Onlne
Job ID: 17-MECH-2982 - install one (1) 5-to Tax Amount: $0.00
n 60K-ETU AHU TP - Trade Permit Base Fee
Card M
$55.00
Amountr Information:Dnm115.00
SALE AMOUNT $119,00
Tender Cash $119.00 ;
Tender Type: CC
Tender Amount: $119.00
Change Due: $0.00
CUSTOMER COPY
PERMIT IS APPROVED ONLY IN ACCORDANCE WIFII ALL CITU OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
MECHANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233
Ph(904)247-5826 Fax(904)247-5845 n _A e Ct} _ Qct z
JOB ADDRESS: ) 1-\�C� Kik�y1k 6 i1n z Ott. ( \ r-I\it_ PERMrr# ) b srn all
PROJECT VALUE$ q7�d
NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION
. Air Conditioning: Unit Quantity I Tons Per Unit /
Heat: Unit Quantity i BTU's Per Unit (40,000 Seer Rating
Duct Systems: Total CFM REQUIRED
REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION
ARI#
Air Conditioning: Unit Quantity Tons Per Unit REQUIRED
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 authority to violate the provisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name K V e :S;d e i M,,s Phone Number
Mechanical Company A1C P s,' ..s )1,) --)•-< Office Phone-1-1.)-Q991-- Fax a� yy
n l
Co.Address: LI LI 5 ) r'C.3 c— 1�-a w 1 , S Iv` k Jti'11 City 1S o.,,i.it State Zip a1).),"
License Holder(Print): C�►-.a,. /Ls S, C1-►‘.L Sta''-"K�r�.": •n/Registration# (-4(?a) 3i51/
Notarized Signature of License Holder `mw
Sworn and subscribed before 1 'this ILLII d�x o J' n t-w e 7 20.L...
DEBRA ANN HOISINGTON Si ature of No Public J ,��� /ll '�.,-„
•':MY COMMISSION 0 00031926 '
;� '.,' EXPIRES October 13.2020 a /A n C /v,Ll a
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