2069 BEACH AVE - HVAC r_,,_- L`1,.
41 4 \ \ CITY OF ATLANTIC BEACH
J
A� j 800 SEMINOLE ROAD
t_
� yr 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: 16-MECH-2880
Job Type: MECHANICAL HVAC ONLY
Description: HVAC - 1 AC, 1 AHU, 2 TON
Estimated Value: $13,271.00
Issue Date: 12/28/2016
Expiration Date: 6/26/2017
PROPERTY ADDRESS:
Address: 2069 BEACH AVE
RE Number: 169718-0000
PROPERTY OWNER:
Name: FERGUSON, LEE
Address: 2069 BEACH AVE
GENERAL CONTRACTOR INFORMATION:
Name: SERVICE EXPERTS
Carey L. Zarm, CAC1817129
Address: 8475 WESTERN WAY STE 100 QA CAREY ZARM
IPhone: - -
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:
Furnaces and Heating $24.00
I
AC and Refrigeration $16.00
State Mech DBPR Surcharge $2.00
State Mech DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $99.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND 'HIE 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 1 1!O--(V,E-C14 - Z_B80
FOB ADDRESS: o P PERMIT#
PROJECT VALUE $ 13 a �2 ARI# �j cl) 2a REQUIRED
Air Handling Equipment Only Air Handling Unit & Condenser Condenser
NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity e 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 I Tons Per Unit
Heat: Unit Quantity / BTU's Per Unit] �C>� Seer Rating .Z2 00 C)
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
tis 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
ot. 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 Le c /- 6'/L Gt So A., Phone Number a Y9 -U/c/
Mechanical Company Service Experts Office Phone 271-2182 Fax
Co. Address: 8475 Western Way Suite 100 City Jacksonville State FI Zip 32256
License Holder(Print): Carey Zarm tate Certificat. Registration# CAC 1817129
Notarized Signature of License Holder `C.Z>
Before me this / day of 20
Signature of Notary Public _ . _�_,. _ i---
;�' '.
rev COMMISSION r F osstxts
.•%: EXPIRES:July 5,2018
Bonded Thru Notary Pudic Underwers
• NOTICE OF COMMENCEMENT
• (PREPARE IN DUPLICATE) •
•
• Permit No. Tax Folio No.
State of tO 2l 4OA County of p(A V A 1_
•
To whom it may concern: •
The undersigned hereby informs you that improvements will be made to certain real property,and in
. accordance with Section 713 of the'Florida Statutes,the following information is stated in this NOTICE OF•
COMMENCEMENT. //
• Legal scription of property being improved: C f bq OO
. /l - q3 OSI ` S - � `l
N .41, J /.iT•/c f f/9Cx/ �/,/,d /i • i f/)T 4..c' • - 7 " 1 75 .
. Address of property being improved: aU 69 8e i9 C N 1T y e
/4-7 4,4 /--, r- is p /1 F t 3 c� X3:3 . _
General description of improvements: /. VA'
•
Owner 1,e-1 e. Fe § Q s0 i-.1 .
Q
Address d (a 5 a e 4 ci4 G. V e o-7--,c.A-N r i c ,C ,see gel / G
Owner's interest in site of the improvement 0 CA) /Lf ell._ 3r )-..)..33
Fee Simple Titleholder(if other than owner) ' •
Name .
Address
(� Contractor S{1 fZ L)1 Cc ��' tem S V
V Address Yo�I,S 4.)-� S Tel /il Z.tl Su /7-F' /C? O j,"9- F
�� ft, Phone No.• l� V7 / c-3 3 Fax No. 4/6 v'-0/:j 7 3 c �.
Surety(if any) • • ._ _. .
.. Address Amount of bond$
Phone No. Fax No. ..•
. Name and address of any person making a loan for the construction of the improvements.
Name
Address ••
Phone No. Fax No.
Name of person within the State of Florida,other than himself,designated by owner upon whom notices or other •
documents may be served: .
• Name
.4-41k.
• Address _
Phone No. Fax No. Z5 /
In addition to himself,owner designates the following person to receive a copy of the Lienor's Notice as provided in • r,•t
Section 713.06(2)(b),Florida,Slatutes.(Fill in at Owner's option). . 22 4 pa
Name • bf•rmn�'„
Address 2'4153
Phone No. Fax No. if
•Expiration date of Notice of Commencement(the expiration date is one(1) ?fro the date of recording unless a
Ilig
different date is specified):
THIS SPACE FOR RECORDER'S USE ONLY •�ER
•
t
• Sign,':. / ._ DATE �� 07ali(ce
.
Bei•fe a "�'� •. .7 AV'„,, - 4' ' 1 the
Co io euval,St •,,,.•n'Q�,has B$rso.•Ily appe.
!Z �C Ci herein by
himsetf/herself and affirms that all =laments and declarations herein
are true and accurate
• Doc#2016294694,OR BK 17824 Page 979,
Number Pages:1
Recorded 12/28/2016 at 11:40 AM,
•
AAA),
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Ronnie Fussell CLERK CIRCUIT COURT DUVAL
COUNTY Notary Pub IC al Large.State of L�ountyo���T
My commission expires:
RECORDING$10.00 Personally Known ^or•
Produced Identification 0