2221 ALICIA LN - HVAC d
j\ CITY OF ATLANTIC BEACH
o 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: ACRS17-0055
Description: 2 A/C, 2 AHU, 3 TON & 5 TON
Estimated Value: 0
Issue Date: 6/7/2017
Expiration Date: 12/4/2017
PROPERTY ADDRESS:
Address: 2221 ALICIA LN
RE Number: 169519 0770
PROPERTY OWNER:
Name: BRADY KYLE
Address: 2221 ALICIA LN
ATLANTIC BEACH, FL 32233-5975
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
,
Phone:
Name: NC DESIGNS OF ST AUGUSTINE
Address: 103 LIBERTY CENTER PL QA EDWARD DOUGLAS TENNANT
ST.AUGUSTINE, FL 32084
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 and estimated value of$7,500.
1
MECHANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph (904) 247-5826 Fax (904) 247-5845
JOB ADDRESS: a_1 a.,01 I'1 a ,iM , PERMIT# AaRs(7-0055
833raS(o
PROJECT VALUES � n00 >.4)COY ARI# S q(1 „VD REQUIRED
Air Handling Equipment Only t� 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 _ Sccr Rating _
Duct Systems: Total CFM REQUIRED
REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity r Tons Per Unit ,
Heat: Unit Quantity BTU's Per Unit. MAO Seer Rating 1r 0
Duct Systems: Total CFM REQ IRED
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 PIPING Heat Exchanger
Quantity of Outlets Pumps
#Vented Wall Furnaces Refrigerator Condenser B'l'U'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 he true and correct. All provisions of laws and ordinances governing this work will he complied with whether specified or
not. The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name ) 412 A A ,1 Phone Numbete A 3:a' 16..s-
Mechanical Company `f0,11��U� o0--c� s-} Office Phoni����9$$�'�
1. `�
"A "�V
Co. Address: ,3396 aC LLUITIIA16 (� OA. City ,,,C.-4 !lila. State iL Zip (.3A09,
`� l 8 3.3
License Holder(Print): F� �P.�1 na n. .��� State Certification/Registration #�,1�� _�. 2)
Notarized Signature of License Holder lV g
Before me this 5 day of 2.-/An, 20 11
Ariel K.Santny
=:6. NOTARY PUBLIC Signature of Notary Publ�
y ',STATE OF FLORIDA /
...... . Cann*FF974640 '�/C (-LS k.T-V I �`� �'S l�`l j� s rM
19'1 Expires 3/23/202n 66 e
r„t
.,„,....„ r,s,
.,,,,c'; Cash Register Receipt Receipt Number
City of Atlantic Beach R1720
..,_t.-- ri.7,1,)
DESCRIPTION I ACCOUNT QTY PAID
PermitTRAK $99.00
ACRS17-0055 Address: 2221 ALICIA LN APN: 169519 0770 $99.00
MECHANICAL $95.00
AC AND REFRIGERATION 455-0000-322-1000 2 $16.00
FURNACES AND HEATING 455-0000-322-1000 2 $24.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
STATE SURCHARGES $4.00
STATE DBPR SURCHARGE 455-0000-208-0600 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0700 0 $2.00
TOTAL FEES PAID BY RECEIPT: R1720 $99.00
CITY OF ATLANTIC BEACH
800 SEMINOLE RD
ATLANTIC BEAC,FL 32233
0607,2017 10:17:36
CREDIT CARD
MC SALE
Card» XXXXXXXXXXXX2221
SEQ;y: 2
Batch;x: 380
INVOICE 2
Approval Code: 08233J
Entry Method: Mrival
Mode: Onlne
Tax Amount: $0.00
Card Code: M
SALE AMOUNT $99,00
CUSTOMER COPY
Date Paid: Wednesday, June 07, 2017
Paid By: A/C DESIGNS OF ST AUGUSTINE
Cashier: BA
Pay Method: CREDIT CARD 2
Printed:Wednesday,June 07,2017 10:19 AM 1 of 1
TWAT