306 12TH ST - HVAC CITY OF ATLANTIC BEACH
l 800 SEMINBEACHLE FL ROAD
vel ATLANTIC O,
INSPECTION PHONE LINE 247-5814
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J1i19''
MECHANICAL HVAC PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-MECH-2885
Job Type: MECHANICAL HVAC ONLY
Description: Add Ductwork Only. Add 2 supply + 1 return to addition
upstairs.
Estimated Value: $600.00
Issue Date: 12/28/2016
Expiration Date: 6/26/2017
PROPERTY ADDRESS:
Address: 306 12TH ST
RE Number: 171923-0000
PROPERTY OWNER:
Name: Tousey, Clay B III
Address:
GENERAL CONTRACTOR INFORMATION:
Name: OCEAN STATE HEAT & AIR,INC.
, CAC049310
Address: 1476 ATLANTIC BLVD QA JAMES GLENN JONES
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:
State Mech DBPR Surcharge $2.00
State Mech DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $59.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
0
MECHANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH FAX FC
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904)247-5826 Fax (904) 247-5845
JOB ADDRESS: -3O1D 12 t S.+ , PERMIT# 16 P 6f+H-2cPas
PROJECT VALUE $ 600 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 4 Up - Add putt-v./Alt oill REQUIRED
Manual J documentation required on residential changout
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)
p�WUI,k = Wells t
OTHER: GQ. .2 S ei - fc' un, -f I C�1-t'IU' 4a�'
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 authori to violate the provisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name la: .1-DtASEV6 Phone Number 1O' - 9'O.-1,112
G� t A 2t41 2S1 Fax 249-Ilq
Mechanical Company O rr�� Si-� � Office Phone
Co. Address: New A+I t Ly1 I x- Bi Y t{• City N ep#uL'x. MCI() State Zip 324 k
License Holder (Print): 1• Cile i in 7)It - S State Certification/Registration# CRC-04q30
Notarized Signature of License Holder `%‘01�
YVETTE P.MORALES Before me th .'I •.y of DfCCrr 20 1
NOTARY PUBLIC f� 11D
': STATE OF FLORIDA Signature of Notary Public wL'fit mol
44att a Commit EE879174
•b.." (. Expires 3J212017