1723 MARITIME OAK DR - HVAC 11
' ° it CITY OF ATLANTIC BEACH
`=,.. > 800 SEMINOLE ROAD
,� ATLANTIC BEACH, FL 32233
,;i �a INSPECTION PHONE LINE 247-5814
MECHANICAL RESIDENTIAL HVAC -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: ACRS17-0133
Description: HVAC- 1 NC, 1 AHU, 4 TON
Estimated Value: 0
Issue Date: 8/2/2017
Expiration Date: 1/29/2018
PROPERTY ADDRESS:
Address: 1723 MARITIME OAK DR
RE Number: 169505 1775
PROPERTY OWNER:
Name: RIVERSIDE HOMES OF NORTH FLORIDA INC
Address: 12276 SAN JOSE BLVD STE 120
JACKSONVILLE, FL 32223
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: NC 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$7,500.
4
MECHANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233 P CRS i 7- b t 33
y�Ph(904)247-5826 Fax(904)247-5845
JOB ADDRESS: Ilc3 I'lea v,i 1-..ene l rAVa PE1u�IIT#/-7'SrR-3��5Dl
OrL.1 _
PROJECT VALUE$ 69DO
NEW AIR CONDITIONING & HEATING SYSTEM INNTALLATION
Air Conditioning: Unit Quantity I Tons Per Unit
Heat: Unit Quantity I BTU's Per Unit )Ola) Seer Rating I QED
Duct Systems: Total CFM I b Q I
REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION
AR!#
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)
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
#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.1 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
or not. The permit does not give autho' to violate the provisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name ;\1 c,/s*� cue i war. s • • Phone Number
Mechanical Company /41 C PL._, ka LI U4-t' Im , Office Phone-l')-) 95 Fax 7c )-Y9y4i
Co.Address: Ll'1 5 i e 'c . VC.,>K A S . J. JulCity .T5 € 'co.,✓.)i< State ice- Zip3-)005
c)S
License Holder(Print): Cit, lis S. C. , •
itc • •C_rt•. c"ation/Registration#C
h1X 1..3?�1
r License Holder /-1/.../-1/... - 4-,.—
Notarized Signature o f
'ya
Sworn and subscribed before me/this. -4.l)� day f (4 1 1 20
ail DEBRA ANN HOISINGTON ��
•, 'p MY COMMISSION#00031926 Signature of Notary Public Lk- „• ,` .
A
:,a7.1 EXPIRES October 15.2020
/� „\ Cash Register Receipt Receipt Number
7.*) , , City of Atlantic Beach R2175
DESCRIPTION I ACCOUNT QTY PAID
PermitTRAK $170.00
ACRS17-0133 Address: 1723 MARITIME OAK DR APN: 169505 1775 $91.00
MECHANICAL $87.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
AC AND REFRIGERATION 455-0000-322-1000 1 $8.00
FURNACES AND HEATING 455-0000-322-1000 1 $24.00
STATE SURCHARGES $4.00
STATE DBPR SURCHARGE 455-0000-208-0600 0 $2.00
STATE DCA SURCHARGE 45500002080700 0 $2.00
ACRS17-0134 Address: 1644 W PARK TER APN: 172020 0164 $79.00
MECHANICAL $75.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
AIR DUCT SYSTEM 455-0000-322-1000 1 $20.00
STATE SURCHARGES $4.00
STATE DBPR SURCHARGE 455-0000-208-0600 0 $2.00
STATE DCA SURCHARGE 45500002080700 0 $2.00
TOTAL FEES PAID BY RECEIPT: R2175 $170.00
CITY OF ATLANTIC BEACH
800 SEMINOLE RD
ATLANTIC BEAC,FL 32233
0602;2017 0842:52
CREDIT CARD
MC SALE
Card; XXXXXXXXXXXX9016
SEQ : 1
Batch 4: 417
INVOICE 1
Approval Code: 06041C
Enhry Method: Manual
Mode: Onl,e
Tax Amount: $0.00
Card Code: M
SALE AMOUNT $170,00
Date Paid: Wednesday, August 02, 2017
Paid By: A/C MASTERS HVAC INC
Cashier: BA CUSTOMER COPY
Pay Method: CREDIT CARD 1
Op
Printed:Wednesday,August 02,2017 8:45 AM 1 of 1 ii
IR MT