1757 ATLANTIC BEACH DR - GAS PIPING (2) �s f CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
J f.. ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
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MECHANICAL GAS PIPE PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 17-MCHG-3012
Job Type: MECHANICAL GAS PIPING
Description: GAS PIPING - REPLACE BURNER
Estimated Value: $1,337.00
Issue Date: 1/17/2017
Expiration Date: 7/16/2017
PROPERTY ADDRESS:
Address: 1757 ATLANTIC BEACH DR
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: SETZERS & COMPANY
, 030560
Address: 7660 PHILLIPS HWY BERRY ROBERTS
Phone: - -
FEES:
Gas Pipe Outlets $10.00
State Mech DBPR Surcharge $2.00
State Mech DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $69.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
MECHANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph (904) 247-5826 Fax (904) 247-5845 17- ( t _ _ 30(
JOB ADDRESS: 115/ 14 aJ-L a- -d- bf2-. PERMIT#
PROJECT VALUE$ 1337.5 D 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
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: R opkace Opo 13UT u c kx1)
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 t'4-.A, C&4 n L) Phone Number 306-52)5-5
Mechanical Company
(---,.,)e-TZ-C.r5 Office Phone 731 7' 9 Fax 73J-89 3,5
Co. Address: 7.e10 O Phi )�i() City 7;116 State L Zip 3c�0-57v
License Holder (Print): Bo(N 1_010.J2_gAs ate Certification/Registration# 306626
Notarized Signature ofLicense Holder % `��%
g J
;�1�ir';y� TONT GINOLESPERGER Before me this (71
dayof 0 iak I 2 17
a; � :, MY COMMISSION FF 924951 _�
y,* EXPIRES:October 6,2019
(j)fi, tk fwndedThruNo!aryPub 6cUnderwnters t Signature of Notary Public •