1933 Seminole Rd HVAC permit CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
MECHANICAL RESIDENTIAL HVAC -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: ACRS17-0039
Description: replace 3.5-ton 41K-BTU AHU
Estimated Value: 7500
Issue Date: 5/26/2017
Expiration Date: 11/22/2017
PROPERTY ADDRESS:
Address: 1933 SEMINOLE RD
RE Number. 169542 0524
PROPERTY OWNER:
Name: HOLLEY CECIL M
Address: 13711 SHIPWATCH DR
JACKSONVILLE, FL 32225-5404
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: FLORIDA HOME AIR COND DBA ARS
Address: 4211 EMERSON ST CIA DENNIS M BROWN
JACKSONVILLE, FL 32207
Phone:
PERMIT INFORMATION:
Please see attached conditions of approval.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOU PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB
SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN
FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
*A notice of Commencement is only required for work exceeding an estimated value of
$2,500. For HVAC work, a Notice of Commencement is only required when HVAC work
exceeds an estimated value of$7,500.
MECHANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233
P7h(904)247-5826 Fax(904)247.5845 O 3�
IOB ADDRESS: J SG "'� "' O Z ZG 'e v PERMrr#
PROJECT VALUES D o ARI# �6 S'j 9� REQUIRED
,_Air Handling Equipment Only �Air Handling Unit& Condenser _Condenser Only
4EW AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity Tons Per Unit Seer Ratinw
Heat: Unit QuantityBTU's Per Unit REQUIRED
Duct Systems: Total CFM
tEPLACEMENT AIR CONDITIONING & HEATING SYSTfiM INSTALLATION
— /
Air Conditioning: Unit Quantity Tons Per Unit -/ / C/7
Heat: Unit Quantity� BTU's Per Unit ' Seer RatingREQUIRED
Duct Systems: Total CFM
IRE PREVENTION
Fire Sprinkler System Quantity (Requires 3 sets of plans)
)
Fire Standpipe Quantity (Requtres 3 sets of plans)
Underground Fire Main Value (Requtres 3 sets or 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)
rIRE PLACES MISCELLANEOUS:
Prefabricated Fireplace Qty— Automobile Lifts
Gas Piping Outlets Boilers BTUs
Elevators/Escalatom
1,LL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets Pumps
#Vented Well Fumaces __ Refrigerator Condenser BTU's
#Water Heaters Solar Collection Systems
Tanks(gallons)
Wells
)THER: C h �I c out /�i f L
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iu application and know the wmcla0.aue mdcmal. All pmvWtas or lows and adlnmm governing lhb wok wnl be conviid wid whether epmirvll
d. The permit doer not give eudoriry to vldMe lhepmvWafu army other sole at laenl law teaulnliel waafvedm nrthe pafmmmrco ofee"Mcli
'mperty Owners Name,
�' c�G /L /1� //i/Lop, Phone Number 90 y- d° "11.2"
dechanical Company //DJW&K lL/c 0fficePhona77 -1/7j+ Fox±oY- 177- f.ffy
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.o. Address: 2 ro399
,kerne Bolder(Print): ---�
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lorarized Signature o ' e ter i I
CAROLYN N.WRNEN20 I I
r'°�°jw gonry PO He-6lsool FWW fore me this 25 day of
o _ Lamm1, lon Y FF200176 sstore of Notary Public My Cannan.No, M,16,201
'^ft6a4' tbmtllhwMlatlond Nxar ' I/ �(tiUl.LTv—
i
NumberCash Register Receipt Receipt
City of Atlantic Beach R1636
DESCRIPTION ACCOUNT CITY PAID
PermitTRAK $107J$107.00
00
ACRS17-0039 Address: 1933 SEMINOLE RD APN: 1695420524 MECHANICALAC AND REFRIGERATION 455-0000-322-1000 4 FURNACES AND HEATING 455-0000-322-1000 41000 MECHANICAL BASE FEE 455-0000-3223000 0STATESURCHARGESSTATE DBPR SURCHARGE 4550000-209-0600 0
STATE DCA SURCHARGE 4550000-208-0700 0 $2.00
TOTAL FEES PAID BY RECEIPT: R1636 $107.00
Date Paid: Friday, May 26,2017
Paid By: FLORIDA HOME AIR COND DBA ARS
Cashier: CT
Pay Method:CREDIT CARD 095485
Printed:Friday,May 26,2017 4:14 PM 1 of 1