350 3rd St mchg permit ,n CITY OF ATLANTIC BEACH
S%! j 800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
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MECHANICAL GAS PIPE PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 17-MCHG-3282
Job Type: MECHANICAL GAS PIPING
Description: install 3 gas outlets, water heater, 250 gallon tank
Estimated Value: $1,345.00
Issue Date: 2/16/2017
Expiration Date: 8/15/2017
PROPERTY ADDRESS:
Address: 350 3RD ST
RE Number: 169784-0000
PROPERTY OWNER:
Name: Henderson, Jacqueline
Address: 350 3Rd ST
GENERAL CONTRACTOR INFORMATION:
Name: FLORIDA PROPANE PARTNERS
Address: 461 TRESCA RD TIM CALLAHAN
Phone: - -
FEES:
Gas Pipe Outlets $10.00
Gas Piping Vented Units $5.00
State Mech DBPR Surcharge $2.00
State Mach DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $74.00
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 —IAC H(1 _3a
JOB ADDREss: 3<-b ,Z cA, PERMIT#
PROJECT VALUE $ 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 QtyAutomobile Lifts
Gas Piping Outlets Boilers BTU's
Elevators/Escalators
ALL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets _C 3 Pumps
#Vented Wall Furnaces Refrigerator Condenser BTU's
#Water Heaters Solar Collection Systems
Tanks(gallons) 21 t'�C=l
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 time and coned. All provisions of laws and ordinances governing this work will be complied with whether specified or
not The permit does not give aullon to violate the provisions of any other state or local law regulation cammuction or the performance of construction.
Property Owners Name S-.� �c.Q..n��c:.� Phone Number Svy (09 47
Mechanical Company fLf r` s mo,nt �ff�,nt (S OfficePhonefW7,3YY343 Fax of 73
Co. Address: (-e S C', City ck -tic State . Zip ZZ Z
License Holder(Print): Lf f Z State Certification/Registration# -PN t Z-C
,p ' � NYCOMN19910NNGG 01]9!6 tF�"" ��w.; IxPwl:s:oemoun.mm Before ethis �l0 day of� lu.G-fl 20 14
�;' r.,;,,� IlonaM nry ramraaur ua.rna.
ignature of Notary Public J�M,4 +.-�