363 12th St mchg permit -S iyl,yy,
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
MECHANICAL GAS PIPE PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 17-MCHG-2998
Job Type: MECHANICAL GAS PIPING
Description: install 5 gas piping outlets & one (1) 120 gallon tank
Estimated Value: $1,600.00
Issue Date: 1/24/2017
Expiration Date: 7/23/2017
PROPERTY ADDRESS:
Address: 363 12TH ST
RE Number: 171917-0000
PROPERTY OWNER:
Name: Hand, Michael B
Address:
GENERAL CONTRACTOR INFORMATION:
Name: PROGASCO, CORP.
,09274
Address: 7709 ALTON AVE
Phone: - -
FEES:
Gas Pipe Outlets $12.00
State Mach DBPR Surcharge $2.00
State Mach DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $71.00
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
I'A- MLNC,-ao15 g
Jon ADDRESS: 3 63 /a "I Sl' PERm rr#
PROJECT VALUE $ /G UL - 0 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 PH'ING Heat Exchanger
Quantity of Outlets S Pumps
#Vented Wall Furnaces Refrigerator Condenser BTU's
#Water Heaters Solar Collection Systems
Tanks(gallons) r /.YD S"^is
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 cored. 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 ofany other state or local law regulation construction or the performance of construction.
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Property Owners Name
0 N P l 8,11ee 14, � Phone Number
Mechanical Company ao 9 AWZ 4�,o Office Phone 72/ST it Fax
Co. Address: "0? A /�uAu &4 !. City dAy State ft Zip3Z2 s 3
License Holder(Print): EwiN 211C114N& lState Certification/Registration# 9ez 9y
Notarize([ olderttt��� nnnn ' /J
.y+tt comlanERJGNNGTGN day Of 20
MyrAMMISSIGN#GG CANP Before 5
EYJIFES'.GR>Dar2l.3ala
,s goayryTlw NohM^o'kw°'"`""" Signature of Notary Public AMA NA T