356 10th ST - HVAC ri y�Jf J,v
d ' � CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
1 ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
�J3
MECHANICAL RESIDENTIAL HVAC -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: ACRS17-0086
Description: HVAC -2 NC, 2 AHU, 2 TONS EACH
Estimated Value: 0
Issue Date:
Expiration Date:
PROPERTY ADDRESS:
Address: 356 10TH ST
RE Number: 170043 0000
PROPERTY OWNER:
Name: EZELIUS PER OLOF
Address: 356 10TH ST
ATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: A/C MASTERS HVAC INC
Address: 11243 ST JOHNS PKWY APT 3 QA CHARLES STEVEN
CRABTREE
JACKSONVILLE, FL 32246
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$7,500.
MECHANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233 n
Ph(904)247-5826 Fax(904)247-5845 4 C R S 17- 008 C ,
JOR ADDRESS: '554 ) l ''' S tl-r•' 1- PERMIT# /7—.CFS-A-3/
PROJECT VALUE$ )'/O 5,
NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity a Tons Per Unit - i r
Heat: Unit Quantity A BTU's Per Unit 'c iI L Seer Rating i -) ,
Duct Systems: Total CFM 1(-.0 L' REQUIRED
REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION
ARI#
Air Conditioning: Unit Quantity Tons Per Unit REQUIRED
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)
11
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 BTU's
i #Water Heaters Solar Collection Systems
Tanks(gallons)
Wells
OTHER: De... iA u:.i 1 (\.; C-1 c.4 (,i. I k 1 ':- X. I 0.)
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
I 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.
1 6- i• Lk
Property Owners Name j_j., --) 1 t,,, : e aze-c l Phone Number 1• ) ,
1� 1 (1 PL..a�.,s I-� \; A e1 i -- c Office Phone�).) J`!S Fax )-A.) (i()III/
Mechanical Company _
Co.Address: L L 7-col/ City )u: E.l 6.70., ) L State i-L Zip,'
License Holder(Print): ( �r le, . (. rt.\,)-I v e State -• ; ;+ •: t -tistration# ( I I J6,)1
Notarized Signature of License Holder ... — .. f --,----
worn and subscribed before me Tiis, day ��� 20 1 1
;pii''' s DEBRA ANN HOISINGTON
` ll //�
MY COMMISSION#GGo31s2! ignature of Notary Public .J `_i l: < < . _
•,� •t(, EXPIRES October 15,2020
1
,•; ,1, Cash Register Receipt Receipt Number
City of Atlantic Beach R1905
DESCRIPTION I ACCOUNT I QTY I PAID
PermitTRAK $99.00
ACRS17-0086 Address: 356 10TH ST APN: 170043 0000 $99.00
MECHANICAL $95.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
AC AND REFRIGERATION 455-0000-322-1000 2 $16.00
FURNACES AND HEATING 455-0000-322-1000 2 $24.00
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: R1905 $99.00
CITY OF ATLANTIC BEACH
800 SEMINOLE RD
ATLANTIC BEAC,FL 32233
07052017 10:37:16
CREDIT CARD
MC SALE
Card 3 XXXXXXXXXXXX9016
SEQ#: 2
Batch u: 399
INVOICE 2
Approval Code: 0:.:'8G
Entry Method: Manual
Mode: Online
Tax Amount: $0.00
Card Code: M
SALE AMOUNT $99,00
CUSTOMER COPY
Date Paid: Wednesday,July 05, 2017
Paid By: A/C MASTERS HVAC INC
Cashier: BA
Pay Method: CREDIT CARD 2
Printed:Wednesday,July 05,2017 10:38 AM 1 of 1 114