825 SHERRY DR - HVAC LA
'S hua
� -4° 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: ACRS17-0208
Description: HVAC- 1 A/C, 1 AHU, 5 TON
Estimated Value: 0
Issue Date:
Expiration Date:
PROPERTY ADDRESS:
Address: 825 SHERRY DR
RE Number: 169983 0000
PROPERTY OWNER:
Name: GRAY ADAM R
Address: 826 9TH AVE N
JACKSONVILLE BEACH, FL 32250
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: AIR SYSTEMS OF LAKELAND LLC
Address: 5615 LAUREL OAK DR
LAKELAND, FL 33811
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.
Oct 2517 07:59p Gary Graham 863-647-5345 p.2
MECHANICAL PE ' I T APPLICATION
CITY OF ATL ' C BEACH
800 Seminole Rd Atlanti Beach,FL 32233
Ph(904)247-5826 F. (904)247-5845 j Q gS 17- 0 Z OS
1013 ADDRESS: 2 1 C; c br PERMIT#A>eS I 9-O0143
PROJECT VALUE $ - ' # REQUIRED
Air Handling Equipment Only X Air Handl g Unit & Condenser Condenser Only
s EW MR CONDITIONING & HEATING SYSTM INSTALLATION
Air Conditioning: Unit Quantity ( Tons Per nit 5-
Heat: Unit Quantity BTU's P r Unit Co 0 COO 6 Seer i
Rating
Duct Systems: Total CFM Lh tO REQUIRED
[REPLACEMENT AIR CONDITIONING & HEA ING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity Tons Per Unit
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 CELLANEOUS:
Prefabricated Fireplace Qty A tomobile Lifts
Gas Piping Outlets B 'ilers BTU's
E evators/Escalators
kLL OTHER GAS PIPING Hat Exchanger
Quantity of Outlets P ps
#Vented Wall Furnaces frigerator Condenser BTU's
#Water Heaters S tar Collection Systems
Tanks (gallons)
Veils
)THERE - n e- C oftms4 't, =f-s---m
1 1
ermit becomes void if work does not commence within a six month period or wo is suspended or abandoned for six months.I hereby certify that I have read
pis application and know the same to be true and correct All provisions of laws 'd ordinances governing this work will be complied with whether specified or
ot. The permit does not give authority to violate the provisions of any other state 'r local law regulation construction or the performance of construction..
'roperty Owners Name 79l'y ..'J .;IL i A/6 ( ?4y . Phone Number9/ �L �..S`:
Mechanical Company ►f Sn SS t7 t1113 o-r LA-kg/law O Office hat 5 Fax St3‘595:3V5
...6Z7(5 4iir1 / poc-fc d3'- 1-Akel/Win F1 33 F i !
Oct 2517 07:59p Gary Graham 863-647-5345 p.3
i
MECHANICAL PEIi14IT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph (904)247-5826 Fax(904)247-5845
TOB ADDRESS025- UI� R PERMIT# I 7'be
License Holder(Print): 6;5 6: q,,,,ifi4 State Certification/Registration#CAC 18 L3 5(
Votarized Signature of License Holder • dA-------
7Before me this ay of 0 C Q -v- 20 1 -
Signature of Notary Publi 411k.k.,,,..
-
p`PRY pue�i .IENNIFERWU DER
'....f c. MY CCMMtSSIQN R FF 1621
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Cash Register Receipt Receipt Number
City of Atlantic Beach R3344
DESCRIPTION ACCOUNT QTY I PAID
PermitTRAK $123.00
ACRS17-0208 Address: 825 SHERRY DR APN 1699830000 $123.00
MECHANICAL - . $119.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
AC AND REFRIGERATION 455-0000-322-1000 5 $40.00
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: R3344 $123.00
CITY OF ATLANTIC BEACH
800 SEMINOLE RD
ATLANTIC BEAC,FL 32233
11/01/2017 15:13 27
CREDIT CARD
VISA SALE
Card# X)00000000=3:
SEQ#: 10
Batch#: 475
INVOICE 10
Approval Code: 807582
Entry Method: Manual
Mode: Online
Tax Amount: $0.00
Card Code: M
SALE AMOUNT $123,00
CUSTOMER COPY
Date Paid:Wednesday, November 01, 2017 B ��t co r C ,A
Paid By:ADAM GRAY
Cashier: BA
Pay Method: CREDIT CARD 10
Printed:Wednesday,November 01,2017 3:14 PM 1 of 1 �D