825 SHERRY DR - GAS PIPING 44 , CITY OF ATLANTIC BEACH
j ) 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
Dsil9 INSPECTION PHONE LINE 247-5814
MECHANICAL RESIDENTIAL GAS -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION: 1
PERMIT NO: GSRS17-0038
Description: GAS PIPING-2 OUTLETS &ONE WATER HEATER
Estimated Value: 0
Issue Date: 11/3/2017 1
Expiration Date: 5/2/2018
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: ECONOMY PLUMBING COMPANY INC
Address: 1892 ENTERPRISE AVE
ST AUGUSTINE, FL 32092
Phone:
PERMIT INFORMATION:
Please see attached conditions of approv I.
WARNING TO OWNER: YOUR FAIL J RE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT I YOU PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPE TY. A NOTICE OF
COMMENCEMENT MUST BE RECO ED AND POSTED ON THE JOB
SITE BEFORE THE FIRST INSPECT ON. IF YOU INTEND TO OBTAIN
FINANCING, CONSULT WITH YO LENDER OR AN ATTORNEY
BEFORE RECORDING YOUR NOTI E OF COMMENCEMENT.
* A notice of Commencement is only required or work exceeding an estimated value of
$2,500. For HVAC work, a Notice of Commen ement is only required when HVAC work
exceeds and estimated value of$7,500.
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MECHANICAL PE ' I' IT APPLICATION
CITY OF ATL A,NTIC BEACH
800 Seminole Rd Atla 'ic Beach, FL 32233
Ph(904) 247-5826 F.x (904) 247-5845 '
JOB ADDRESS: * • L Il R ./4. PERMIT#.-/- c :7401-
PROJECT VALUE $ (QJ 000 - RI# REQUIRED
Air Handling Equipment Only Air Hand ing Unit & Condenser Condenser Only
NEW AIR CONDITIONING & HEATING SYS EM INSTALLATION
Air Conditioning: Unit Quantity Tons Pe Unit
Heat: Unit Quantity BTU's er Unit Seer Rating
Duct Systems: Total CFM REQUIRED
REPLACEMENT AIR CONDITIONING & HE Al, TING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity Tons Pe lUnit
Heat: Unit Quantity BTU's 'er 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 TyIISCELLANEOUS:
Prefabricated Fireplace Qty utomobile Lifts
Gas Piping Outlets oilers BTU's
levators/Escalators
ALL OTHER GAS PIPIN eat Exchanger
Quantity of Outlets umps
#Vented Wall Furnaces efrigerator Condenser BTU's
#Water Heaters J Solar Collection Systems
Tanks (gallons)
Wells
OTHER: c,-c-c(ce - Fs?Z4 -777 a
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 9 IV) ?A9
-o1J �7' Phone Number
Mechanical Company L C to}vo;f)/ /4)/u vv) .j, 'rv.1 ' Office Phone 3f-- ,%Fax F-a2 �/�//�f
Co. Address: /r-- c2 L'4/%L%A J°/'i)SZ-' A LrL-- City Si.A/1/ /S1. 1' State/L Zip .3a0/a
License Holder(Print): /v2iC4AL=/ //' morvJio _ :•e Certification/Re i tration# Cf c/c/a?7707
Notarized Signature of License Holder / : ��
I TON GINDLESPERGER efore me this 3 ( ay o o
1 ,:i fl', '• MYCOi,/ii�lISSION FF 924951 0
a_______.
f j ",•.F'_ ;�= E?:PIKES:October 6,2019 l'
( ' O rdea Thru N0 Ty Puhfc Urdermiters ignature of Notary Publ1c'! ti
mow _,� �.a=�y � m..�-- ti
€can 0mLjP ( 6 Q Oi .Com
Cash Register Receipt Receipt Number
A� � }
f - -s
City of Atlantic Beach. R3363
DESCRIPTION ACCOUNT I QTY PAID
PermitTRAK $79.00
GSRS17-0038 Address: 825 SHERRY DR APN 169983 0000 $79.00
MECHANICAL - $75.00-
MECHANICAL BASE FEE I.;455-0000-322-1000 0 $55.00
GAS PIPING OUTLETS .;455-0000-322-1000 2 $10.00
GAS PIPING OUTLETS M1455-0000-322-1000 1 $10.00
STATE SURCHARGES _ $4.00
STATE DBPR SURCHARGE '1455-0000-208-0600 0 $2.00
STATE DCA SURCHARGE III 45500002080700 0 $2.00
TOTAL FEES PAID BY RECEIPT: R3363 $79.00
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Date Paid: Friday, November 03, 2017
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Paid By:ADAM GRAY
Cashier: LE
Pay Method: CREDIT CARD 6117
1 ON
Printed: Friday, November 03,2017 1:55 PM 1 of 1 e
mniar