545 CLIPPERSHIP LN - HVAC 4 , yr
` '' " CITY OF ATLANTIC BEACH
0A.. 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: ACRS17-0139
Description: HVAC - 1 A/C, 1 AHU, 3 TON
Estimated Value: 3600
Issue Date:
Expiration Date:
PROPERTY ADDRESS:
Address: 545 CLIPPER SHIP LN
RE Number: 170703 0220
PROPERTY OWNER:
Name: FARACE NORA LEE
Address: 545 CLIPPER SHIP LN
ATLANTIC BEACH, FL 32233-4112
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: AIR PROFESSIONALS
Address: 2725 Shoshone DR
MIDDLEBURG, FL 32068
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) 247-5826 Fax (904) 247-5845 r,
JOB ADDRESS: 5-4 5 C t t s�k P La-t\e. PERMIT# f�ffi/b131
t 1
PROJECT VALUE $ 3(o 00 " 0° Anti S U~IC.(41-5 REQUIRED
_Air Handling Equipment Only )(Air Handling Unit & Condenser Condenser Only
NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity 1 Tons Per Unit 3
Heat: Unit Quantity BTU's Per Unit S.tobv Seer Rating
Duct Systems: Total CFM REQUIRED
REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity Tons Per Unit
Heat: Unit Quantity BTU's Per Unit Seer Rating
REQUIRED
Duct Systems: Total CFM
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:
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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 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 A I V b P- Le e Phone Number
Mechanical Company Ai ( Co FSS<at'P+LS Office Phone I55- 03 Fax
P Y
CitymiblAo ). State Zip 3D0(Q$
Co. Address: o�,aS ShlQslhan� b?....
License Holder(Print): -Srih f\ d State Certification/Registration#(`.h(',t R t(034,
Notarized Signature of License Holder ua
Be a me this 1-* d of L. . _ . "0.- --" 20 1,-7
JOANNE POKRINCHAK
fi"kt. wCOMMISSION#99071545Signature of Notary Public .�.. da V��^`c 9"�'—
MIRES:FEB 09,2021
a^� Bonded through 1st State Insurance
ke
ACash Register Receipt Receipt Number
J ~ City of Atlantic Beach R2398
s v'
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $91.00
ACRS17-0139 Address: 545 CLIPPER SHIP LN APN: 170703 0220 $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
TOTAL FEES PAID BY RECEIPT: R2398 $91.00
CITY OF ATLANTIC BEACH
800 SEMINOLE RD
ATLANTIC BEAC,FL 32233
08/29.2017 10:38:05
CREDIT CARD
VISA SALE
Card# XXXXXXXXXXXX6247
SEQ u: 2
Batch#: 436
INVOICE 2
Approval Code: 113585
Entry Method: Manual
Mode: Online
Tax Amount: $0.00
Card Code: M
SALE AMOUNT $91,00
CUSTOMER COPY
Date Paid:Tuesday, August 29, 2017
Paid By: AIR PROFESSIONALS
Cashier: BA
Pay Method: CREDIT CARD 2
Printed:Tuesday,August 29,2017 10:39 AM 1 of 1
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