81 5TH ST - GAS PIPING y\.N
J AV `S, CITY OF ATLANTIC BEACH
f 800 SEMINOLE ROAD
J� ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
.. / Jl�l�r
MECHANICAL GAS PIPE PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 17-MCHG-3001
Job Type: MECHANICAL GAS PIPING
Description: GAS PIPING - ONE OUTLET
Estimated Value:
Issue Date: 1/17/2017
Expiration Date: 7/16/2017
PROPERTY ADDRESS:
Address: 81 5TH ST
RE Number: 170151-0000
PROPERTY OWNER:
Name: Sabatier, Nadine
Address: 81 5Th ST
GENERAL CONTRACTOR INFORMATION:
Name: FLORIDA PROPANE PARTNERS
, 31206 RYAN RODRIGUEZ
Address: 461 TRESCA RD DEWEY FLOWERS
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 W1711 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 I 7-MCN C _3 00l
JOB ADDRESS: gl c q-_ PERMIT#
PROJECT VALUE $ (0 Y �^ 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
Manual J documentation required on residential change out
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 n.. 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 auth i toviolate the provisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name 461 ne Sc ioc.h Phone Number g d`f S15 or.
Mechanical Company ci.r.A, eroet,tc (ct FICrS 06A Gr,fFF% 6cs • Office Phone fa(Di 1343Fax lo`("ia,a)13
Co. Address: t ((,i ((ZS (.4 e( . City dtc(4SoA kh'i It Status _ Zip :OD- S--
License Holder(Print): _ State Certification/Registration# '" t .-c Q
Notarized Signature o Lic• 1 •.• older , ..
•17.:;•;:"' TONI GINDIESPERGER Before me fhis dayof ��� / 0
L 's MY EXPIRES:
#FF 924951 _.
,:,,•; EXPIRES:October 6,2019 O J •-
�, Banded Tiro Notary Pubk undenfiters Signature of Notary Public