108 SEMINOLE RD - HVAC Aug/31/2016 2'46'07 PM Service Experts 9046460137 2/2
MECHANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233 -
Ph(904) 247-5826 Fax (904) 247-5845
3S ADDRESS: /0 F , 62/10 /N o 4,C'
PROJECT VALUE $ 7 V dc) ARI# ci3, . 1 REQUIRED
Air Handling Equipment Only Air Handling Unit & Condenser Condenser
NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity Tons Per Unit
Heat: Unit Quantity BTU's Per Unit Seer Rating
Duct Systems: Total CFM REQUIRED
REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning; Unit Quantity / Tons Per Unit 3
Heat: Unit Quantity ( BTU's Per Unita 4/6c, U Seer Rating/S5.2 6
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:
ermit 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
s 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
:. 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 , D'O D I°e 7-edi, c/ 1/4 77 i fZ Vy,1 Phone Number ilogi 7 7g 4.3-8.2
Mechanical Company Service Experts Office Phone 271-2182 Fax
Co. Address; $475 Western Way Suite 100 City Jacksonville State Fl Zip 32256
•
License Holder(Print): Carey Zarm tate Certificati Registration# CAC 1817129
Notarized Signature of License Holder
.: efore me this day of 41 c.e 7 20 /
, - =cAROLA.t3RES$LER•
MY COMMISSION#FF0439035i gnature of Notary Public 4 /a
,;4""•4,,.:> EXPIRES:duly 6,2018
'Goaded Thio Rolm Put*undar�rAcs
0.` ` ATLANTIC BEACH
:'`
�ii- 'i PERMIT RECEIPT
A./.-f-i1;__y f August 31, 2016
PERMIT DESCRIPTION: HVAC- 1 AC, 1 AHU, 3 TON
PERMIT NUMBER: 16-MECH-1980 VC ( p _ (' pui. 0 1\ Z
ADDRESS: 108 SEMINOLE RD
OWNER:
Furnaces and Heating $24.00
AC and Refrigeration $24.00
State Mech DBPR Surcharge $2.00
State Mech DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Totals: $107.00
pe- on(4- ( Co nik CCS(
_( 87
rn. 1,-\.-k- be- Q-0 p (..