1395 Main St HVAC permit pi�1
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: ACRS17-0087
Description: HVAC-1 A/C, 1 AHU, 2 TON
Estimated Value: 0
Issue Date: 7/5/2017
Expiration Date: 1/1/2018
PROPERTY ADDRESS:
Address: 1395 MAIN ST
RE Number: 171053 0010
PROPERTY OWNER:
Name: WILKINS DEBRA
1395
N ST
Address. ATLANTIIC BEACH, FL 32233-2625
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: Elite AC, LLC
Address: 10150 Belle Rive BLVD#1407
JACKSONVILLE, FL 32256
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
Ph(904)2r4t7`-,5826 Fax((904)247-5845
JOB ADDRESS: I�GICIfLAnlh CL TrfIQ \ CJr`�^ER�M7TG# AeIZs�7-oo87
PROJECT VALUE S-2-9-1 ARI# �I99 25 LRFQUIRED
_Air Handling Equipment Only Air Handling Unit&Condenser _Condenser Only
NEN AIR CONDITIONING&HEATING SYSTEM INSTALLATIO
Air Conditioning:Unit Quantity Tons Per Unit Seer Hating��� �
Heat:Unit Quantity:__ BTU's Per nu_. REQMED
Duct Systems:Total CFM
REPLACEMENT AIR CONDITIO IGNIDI &HEATING STEM INSTALLATION
Air Condi Quantity:
thy Tom BTU's Per Unit:MOQ Smr tln
Duct Syst QuaMny: REQUHIE
Duct Systems:Total Ct�M
I=PREVENTION
Quantity (Requires 3 sets of plans)
Fire Sprinkler System Q ry (Requires 3 sets of plans)
Fire Standpipe value (Requires 3 sets of plans)
Underground Fire Main Value (Requires 3 sets of plans)
Fire Hose Cabinets Quantity (Requires 3 sets of plana)
Commercial Hoods Quantity (Requires 3 sets of plans)
Fire Suppression Systems Quantity
MISCELLANEOUS:
FIRE PLACES Automobile Lifts
Prefabricated Fireplace Qty— Boilers BTU's
Gas Pinng Outlets
Elevators/Fscalators
ALL OTHER GAS PIPING Heat Exchanger
uantity of Outlets_ Pumps
r
#Qvented Wall Furnaces Refngeamr
#Water Heatersondenser BT 's
Solar Collection Systems
Tankse Is fit}
OTHER: a ons
permit becomes void if wodr does not commence wiMin a si%month period or work ti suspended or abandoned for six m90vetrins. Is
onNs.I hereby
t.and o.oect
terrify
q if will pe complied with applicajon end
know
not.e'fhe permitetloes not give emhorityl for violate the provisions of anvisiom.fl.ws and yo her sure or local
DG6RA 'JJ10 s
law regulation construction or the performance ofwnrmaion. �-
Property Owners Name _ 1D(ll'1 Wfl("d Phone Number Q� 10q_
�11a2 rfC UL Office h ne QV4_N3,
Mechanical Cogen Cityll
tPt=L --
Co.Address:yGz;]
License Holder(Print): State Certification/Registration#CSC ��
Notarized Signature ojLieense Holder
n90
Before me this day of�ne 201py�1
Signature of Notary Public�,_M DJ-1'L_!�,
R--1t'HYiso\ (ZWvv� tvt2�
MARISOLRAmin
..
MV COMMIaelO'Ir rlg55BM
1-4wE%VIRES,nnuary ar.311]0
IKIIYW'tl IYNrM✓wl5xwe elm _
_ awnslEle�
Cash
1 Register•f Atlantic Beach • ,
DESCRIPTION City
PermitTRAK $91.00
ACRS17-0087 Address: 1395 MAIN ST APN: 171053 0010 $91.00
MECHANICAL $87.00
MECHANICALBASE FEE 455-0000-322-1000 0 $55.00
ACAND REFRIGERATION 455-0000-322-1000 1 $8.00
FURNACES AND HEATING 1 455-00011322-1000 1 $24.00
STATE SURCHARGES $4.00
STATE DBPR SURCHARGE 455-0000-208-0600 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0]00 0 $2.00
TOTAL1 11
Date Paid:Wednesday,July 05, 2017
Paid By: Elite AC, LLC
Cashier: BA
Pay Method: CREDIT CARD 5
Printed:Wednesday,July 05,2017 11:39 AM 1 of 1
CITY OFATLANTIC BEACH
800 SEMINOLE RD
ATWMC BBC,FL 32233
07/05/2017 I1:37:50
CREDIT CARD
VISA SALE
Cad# X=WWXW=5256
SEQ#: 5
Barth#: 399
INVOICE
AWOval Code: 5
Entry ftw: 003711
Atonal
Tax Amour onh a
Card Code: $0.00
M
ShE AMOUNT $91,00
CUS70MEER Cour