576 Coastal Oak Ln mchg permit (2) CITY OF ATLANTIC BEACH
[J 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-3157
Job Type: MECHANICAL GAS PIPING
Description: install gas fireplace
Estimated Value: $4,966.57
Issue Date: 2/2/2017
Expiration Date: 8/1/2017
PROPERTY ADDRESS:
Address: 576 COASTAL OAK LN
RE Number: None
PROPERTY OWNER:
Name: HICKS, ANTHONY
Address:
GENERAL CONTRACTOR INFORMATION:
Name: SETZERS &COMPANY
,030580
Address: 7660 PHILLIPS HWY BERRY ROBERTS
Phone: -
FEES:
Gas Pipe Outlets $10.00
Gas Piping Units $12.00
State Mach DBPR Surcharge $2.00
State Mech DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $81.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
MECHANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
n/1 Ph(904)247-5826 Fax(904)247-5845
JOB ADDRESS:(p L�rtic5 I" &t k (04le- PERMIT#
PROJECT VALUE$ Vld , 5 7 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
ElevatomTscalators
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
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 no give authority to violate the provisions of any other state or loca!lal regulation construction or the performance ofconsmuction.
Property Owners Name �f ( •/Y15 W 0Q,k-5 14AA6 v y bf'c k5 Phone Number o20(, 9- V
Mechanical Company Sefze.rS OfficePhone-73/- t4o Fax730 Pf-f5'
Co. Address:110(0 D f/y 1 r�JS City State & Zip
License Holder(Print): P rr c, State Certification/Registration# ,J OJT(p0
Notarized Signature of License Holder
T
MELINDA L.GALLUP efore me this n c0 day of 1=e_h r i, n r w 20 I�
Notmy Public-State M Fbrke i atwe of No Public �^ a
commission♦FF 196796 Notary
*s i My Comm.Expires Apr 16.20t9
•�°L:�� Borinetlthsupb NatlonN Narybn