611 Selva Lakes Cir mchg permit �sJal -
s33 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-3857
Job Type: MECHANICAL GAS PIPING
Description: install gas piping to range & set 2 100-Ib cylinders
Estimated Value: $439.00
Issue Date: 4/28/2017
Expiration Date: 10/25/2017
PROPERTY ADDRESS:
Address: 611 SELVA LAKES CIR
RE Number: 172027-5548
PROPERTY OWNER:
Name: HARMON, DEBRAN L
Address: 611 SELVA LAKES CIR
GENERAL CONTRACTOR INFORMATION:
Name: AEI INTERNATIONAL CORP.
Lewis D.Spradlln,Jr., 19471
Address: 7709 ALTON AVE QA LEWIS SPRADLIN
Phone: 904-724-9771
FEES:
Gas Pipe Outlets $10.00
State Mach DBPR Surcharge $2.00
State Mach DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $69.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ATLANTIC BEACH
!J
PERMIT RECEIPT
gr April 28, 2017
PERMIT DESCRIPTION: install gas piping to range&set 2 100-Ib cylinders
PERMIT NUMBER: 17-MCHG-3857
ADDRESS: 611 SELVA LAKES CIR
OWNER:
Gas Pipe Outlets $10.00
State Mech DBPR Surcharge $2.00
State Mech DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Totals:
$69.00
PAID
APR 2$ 20"
CM OF ATLANTIC BEACH
0C�
ECHANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beady FL 32233
Ph(904)247-5826 Fax(904) 247-5845 — M C E'S
OB ADDRESS: I V Q S /' PERMYr R
PROJECT VALUESARI# RWQUIRED
_Air Handling Equiprn4 Tat Only _Air Handling Unit& Condenser _Condenser Only
(EW AIR CONDITION1 qG & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit tiry Tons Per Unit
Heat: Unit tity BTU's Per Unit Seer Rating,
Duct Systems: Total FM REQUIRED
MPLACEMENT AIR CONDITIONING &HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Q tantity Tons Per Unit
Heat: Unit. tiry BTU's Per Unit Seer Rating
Duct Systems: Total FM REQUIRED
?'IRE PREVENTION
Fire Sprinkler System Quantity (Requires 3 sets of plans)
Fire Standpipe Quantity (Requires 3 sets of plans)
Undergrotmd 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)
!IRE PLACES MISCELLANEOUS:
Prefabricated Fireplace Qty Automobile Lifts
Gas Piping Outlets Boilers Wfu s
Elevators/Escelators
kLL OTHER GAS PIPVT Heat Exchanger
Quantity of Outlets Pumps
#vented Wall Furnaces Refrigerator Condenser BI'C s—
#Water Heaters Solar Collection Systems
Tanks(gallons) -/ 7V
Wells
)THER- eOe, 4-0 r,5M : ao
emit becomes void If work does not corn neswe within a six month period or work is suspended or abandoned for sirs months.I hereby certify that I have read
its appliesdon end know the name to be tr re and eurrem. All provisions of laws mrd ordinances governing this work will be complied with whcther specified or
of The permit does not give audmray w ioiate the provisions of any other state or)Deal lew regulation construction orthe performs oo of construction.
Imperty Owners Name ran Narmb,n Phone Number 382 X900
de chanical Company AD Gar, s4rtyes Office Phone Z4 ax-124 -3-%0
:o.Address: •7'109 141±�n lava city,]af Monvl110 StateFzip 32211
.t use Holder Print): Cl P.�trid ou J�OIt2d lin State Certification/Registration# 991-4
Vo A ' nat F, 1If4&f tVlature
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2 Notary Pa lic-Stere of flo ��t{�
' •- My Comm.t%Plree ddl 1d, re me thisday oft�i•.fP �Q. Commission 0 FF 141206orna7 rnra01saddrsinstsy ofNotary Public
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