339 19th St HVAC permit Sk
CITY OF ATLANTIC BEACH
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: 17-MECH-3054
Job Type: MECHANICAL HVAC ONLY
Description:
Estimated Value: $4,500.00
Issue Date: 1/19/2017
Expiration Date: 7/18/2017
PROPERTY ADDRESS:
Address: 339 19TH ST
RE Number: 172020-1226
PROPERTY OWNER:
Name: GWIZDAK, DANIEL J &VALERIE M, '
Address: 338 19TH ST
GENERAL CONTRACTOR INFORMATION:
Name: DONOVAN HEATING &AIR
,CAC058398
Address: 532 S 3rd ST
Phone: 904-241-3785
PERMIT INFORMATION:Sticker for overcurrent protection must be on A/C equipment prior to
inspection. Failure to comply VIII result in a failed inspection and reinspect fees. No
exceptions.
FEES:
Air Duct System $40.00
State Mech DBPR Surcharge $2.00
State Mech DCA Surcharge $2.00
Trade Permit Base Fee $55.00
WORK W/O PERMIT BUILDING $72.50
Total Payments: $171.50
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
MECHANICAL PERMIT APPLICATION
CITY OP ATLANTIC BEACH
g00 Seminole Rd Atlantic Beach,FL 32233
Ph(904)2447-5826 Fax(904)247-5845 1 -7-(V\ M- 0- 3054-
on
0- 38s4-
On AAARSSSt '339 19 PERMIT ti
,REQUIRED
PROJECT VALUE,$ uQQ; ARI#
_Air Handling Equipment Only Air Handling Unit& Condenser Condenser Only
JEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity 'Eons Per Unit Seer
Heat: Unit Quantity BTU's Per Unit RE UI
Duct Systems: Total CFM
2EPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity Tons Per Unit Sem Ratsa
Heat: Unit Quantity BT[J's per Unit REQUIRED
Duct Systems: Total CFM
i IRE PREVENTION squires 3 sate of plans
Fire Sprinkler System QuantitytitRequires 3 sets of plans;
Fire Standpipe tV1 (Requires
3 sets of plans)
Underground Fire Main slueequires 3 sets of plans)
Fire Hose Cabinets Quantity Requires 3 sets of plans)
Commercial Hoods Qu�arliiry (Requires 3 sets of plans)
Fire Suppression Systems Q
TIRE PLACES MISCELLANEOUS:
Prefabricated Fireplace QtyAutomobile Lifts
Gas Piping Outlets Boilers
Elevators .scelators
ILL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets Refrigerator Condenser BTU's
#Vented Wall Furnaces — Soler Collection Systems
#Water Heaters Tanks(gallons)
Wells
)THER: \�C kk SvixPft S Elh� rabue�i
ormit heoomas void if work does not commenec within a six month period or work is suspended or abandoned for six months.I hereby cmUr'that I have read
ds application and know the smnc to be five and correct. All pmvisions of laws and ordinances Governing this work will be complied with whether Fpecifiad or
ot, The permit does not Give authority to violate the provisions of any other stale or local law mitulation construction or the perPormantt of`IS ori°n.
koperty Owners Name Phone Numbers l r�c/tl
dechanical Company Office TluntgFax
hl
,o. Addres S J�.V c, S City— State Zip
,icense Holder(Print): `
State CerHfication/Registrarion#G�
Vorarired Signature of X leen re Holder - \ \ _____Z 41 3 7 2 S
9et'ore ruer�
RICHARD TOtAPKMS
day of 20
Commission r FF 090399 ---1—�`
Explms July 29,M17 Signature of Notary Public
Y
6 S � �i..
ATLANTIC BEACH
PERMIT RECEIPT
January 19, 2017
PERMIT DESCRIPTION:
PERMIT NUMBER: 17-MECH-3054
ADDRESS: 33919TH ST
OWNER: CITY OF ATLANTIC BEACH
870 SEMINOLE RD
Air Duct System $4000 ATLANTIC BEAC,R 32233
0419,'2017 15:01:53
CREDIT CARD
State Mech DBPR Surcharge $2.00
VISA SAIF
CARD a XXNXX1LYpCC 4445
State Mech DCA Surcharge -$2 00 INVOICE 0011
SEQ a: 0010
Bafdl4: 000480
Trade Permit Base Fee $55.00 Approval Code: D46DI5
Epp MdW: Me'oal
Mode: OnIm
WORK W/O PERMIT BUILDING $72.50 Ta Arm": $OHO
Card Code: M
Totals: SALE AMOUNT $171.50
$171.50
CUSTOMER COPY
19 NO
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