128 SEMINOLE RD #9 - HVAC r
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TY OF ATLANTIC BEACH
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:) 800 SEMINOLE ROAD
7� "rATLANTIC BEACH, FL 32233
'tD;ti> INSPECTION PHONE LINE 247-5814
MECHANICAL RESIDENTIAL HVAC -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: 16-MECH-2480
Description: replace 2.5-ton 28.4K-BTU AHU
Estimated Value: 4728
Issue Date: 9/19/2017
Expiration Date: 3/18/2018
PROPERTY ADDRESS:
Address: 128 SEMINOLE RD 9
RE Number: 170602 0015
PROPERTY OWNER:
Name: N IRENE FARWELL
Address: 128 -9 S SEMINOLE RD
ATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
I Address:
Phone:
Name: DONOVAN HEATING &AIR
Address: 532 S 3rd ST
JACKSONVILLE BEACH, FL 32250
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.
rY , •.� ATLANTIC BEACH
°'-Js) PERMIT RECEIPT
•P-on S)? November 4, 2016
PERMIT DESCRIPTION: HVAC- 1 AC, 1 AHU, 2.5 TON
PERMIT NUMBER: 16-MECH-2480
ADDRESS: 128 SEMIINOLE/RD 9
OWNER: I (
/4 (I (4 '
Furnaces and Heating $24.00
AC and Refrigeration $20.00
State Mech DBPR Surcharge $2.00
State Mech DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Totals: $103.00
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1cz n Ae_ _,A-1. n & 1)\-1 ___ 71t
i
MECHANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233 , t0-CY1 �(_ Z480. Ph(904) 247-5826 Fax (904) 247-5845
' JOB ADDRESS: /Q. -` ,,,i, I.4, ""PERMIT#
PROJECT VALUE $ y-2a s- ARI# _0 .9S ?0—ykiD
Air Handling Equipment Only Air Handling Unit & Condenser —
Condenser Only
NEW AIR CONDITIONING & HEATING SYSTEM. iNSTALLATI:ON
Air Conditioning: Unit QuantityTens Pcr Unit BTU's Pcr Unit Seer Ratin
Heat: Unit Quantity • REQUIREDDuct.Systems: Total CFM ._,,,•-.__..._
REPLACEMENT AIR CONi}ITiONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity _1__ 'Pons Per Unit a.
Heat: Unit Quantity,. _ BTU's Per lJnit aC 1. Seer RatingR REQUIRED
Duct Systems: Total CM!
FIRE PREVENTION 3 sets of lens
Fire Sprinkler System Quantity ___,_._____„ (Requires P )
Fire Standpipe Quantity _ (Requires 3 sets of plans)
3 sets of plans)
Underground Fire Main Value _ ..,�. (Requires
3 sets of plans)
Fire Hose Cabinets Quantity (Requires
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/Bsea(ators
ALL OTHER GAS PIPING Heat Exchanger
Quantity of OutletsPumps
#Vented Wall Furnaces Refrigerator Condenser BTU's
#Water HeatersSolar Collection Systems
Tanks (gallons)
Wells
OTHER:
Permit becomes void if work does not commence within a siN month pericxl or work is<ncpcndcd or ahnndoned for six months.l hereby certify thitt T have road
this application and know the same to be true and correct. All provisinns of laws nod ordinances pc/venting this work will he complied with whether specified or
not. 'The permit does not give authority to violate thep visions of tiny other state or local law regulation construction or the perrormmnee of construction.
Property Owners Name .i-- ct`°- -,\c9�c _._ _.— Phone Number -
Mechanical Company �:Xt _. \.c . _— _Office Phon i: _ X
/ k
3 I`� Ccs C'iiy ._ State ..Zip_ i
raGh
Co. Address: �- -~
License >Fioldcr(Print): �A\ _ ,. tate CcrtiElcati.on/Registration# 3 y 6
Notarized Signature of License Holder 1 J - --
Before me thiee3 day ol. '� .... 20ti 1 6�q} ti.OZ'6z�inrsealdx3 . •` ',, Signature of Notary Public
66£ot° #uolesiwtoo0 ''" ,;, r
i SND10101 QZ1VH0W �+ 'E
::i
This combination qualifies for a Federal Energy
A'r..,11:11/ n Efficiency Tax Credit when placed in service
/ � Mw�►� E RT I F I E IJ between Feb 17, 2009 and Dec 31, 2016,
t'sJW.ahr'direl.kary.oin
•
Certif.icate of ProductRatings
, ....„ ... . .. . .... . ....... ., ......•.... . .. . . .........•....••.• . • .
AHRI Certified Reference Number: 9603990 Date: 11/2/2016
Product: Split System: Heat Pump with Remote Outdoor Unit-Air-Source
Outdoor Unit Model Number: NXH53OGKA**
Indoor Unit Model Number: FXM4X30**AL
Manufacturer: TEMPSTAR
Trade/Brand name:TEMPSTAR
Series name: 15 SEER N SERIES R410A HP
Manufacturer responsible for the rating of this system combination is TEMPSTAR
Rated as follows in accordance with AHRI Standard 2101240-2008 for
orb Unitary
AHRI-sponsored,Air-Conditioning
and Ah role
Heat Pump Equipment and subject to verification of rating accuracy Y p
party testing: -1 ::;, ".,..,��,;.,,. ..,
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