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1627 E Park Terrace - Gas Permit CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 �.77 INSPECTION PHONE LINE 247-5814 MECHANICAL RESIDENTIAL GAS - MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 PERMIT INFORMATION� PERMIT NO: GSRS1 7-0058 Description: Estimated value: 700 Issue Date: 12/28/2017 Expiration Date: 6/26/2018 PROPERTY ADDRESS: Address: 1627 E PARK TER RE Number: 1720200208 PROPERTY OWNER: Nam: BAKER QUINN DAVID Address: 1627 PARK TER E ATLANTIC BEACH, FL 32233 GENERAL CONTRACTOR INFORMATION: Name: Address: Phone: Name: SAWYER GAS OF THE BEACHES Address: 98 PENMAN RD 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. MECHANICAL PERMIT APPLICATION CITY OF ATLANTIC BEACH goo Seminole Rd Atlantic Beach,Fl,32233 Ph(904)247-5826 Fax(904)247-5845 joBAililnnss: Qav\< -TQ xv Loi- PERMrT PROJECT VALUE ARI# EQUIRED _.Air Handling Equipment Only —Air Handling Unit&Condenser —Condenser Only KEw AIR CONDITIONING &HEATING SYSTEM INSTALLATION Air Conditioning: Unit Quantity Tons Per Unit — Socir Raflng_ Heat Unit Quantity BTU's Per Unit— REQUIRED Duct Systems: Total CFM REPLACEMENT 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 FIRE PREVENTION Fire Sprinkler System Quantity (Requires 3 sets of plans) Fire Standp' Quantity (Requires 3 sets of plans) UndergroffFire Main Value Requilres 3 sets of plans) Fire How Cabinets Quantity =uhres 3 sets of plans) Commercial Hoods Quantity (Requires 3 sets of plans) (Requires 3 sets of plans) Fire Suppression Systems Quantity FIRE PLACES MISCELLANEOUS: Prefabricated Fireplace Qty__. Automobile Lifts ff�us Gas Piping Outlets Boilers ALL OTHER GAS PIPING Heat Fxcbangff Quantity of Outlets n1a Pumps Refrigerator Condenser TT_UTS____ #Vented Wall Furnaces — Solar Collection System #Water Heaters 4�1_ Tanks(gallons) Wells OTHER: imnit b,,omes lroldifwWk-does not womanize witb a S7;� th�puiodffwork is sompendedallbaralono for si.mormas A hereby-1tifY 1 ha"no his appiicafion and know the saboo to be mue and CO� All provision,of lam and ondmannues governing this work will be complied with wholer specified Or lot The permit does not gi,ve authority to violate the provisions of my other sms,or local law regulation=smwaon u the perfornbace of construction, Property Owners Name �a�gc Phone NuvnberqL41_6q9yaL_ office Phone2&_!oALFax2WM� Co.Address: CIS 6. rj�jDnn (Rd: City_�T �Statet—L zi License Holder(Print): I State Certificatioti/Registrartion# _�S'H;defre me 11.1de I"ev DE=A�t lure me a4yof is, ED(PIRES MmOil 28,IWI S gnature of Notary Publizkj_�� Cash Register Receipt Receipt Number to City of Atlantic Beach R3791 DESCRIPTION ACCOUNT CITY PAID 7Pe—rmitTRAK $89.00 GSRS17-0058 Address: 152� APN: 172020 0208 $89.00 MECHMICAL $85.00 MECHANICAL BASE FEE 4'��OltMi-i000 0 $55.00 T5_0000_-i GAS PIPING OUTLETS 5 3 1000 4 $10.00 TANKSGASORUCLUEFED 455-0000-322-1000 100 $20,00 STATE SURICKARGES $1.00 STATE DBPR SU RCHARG E 55-0000-208-0600 �!0 S2'000 L, I STATE DCA SURCHARGE 4 SOM0208070D TOTAL FEES PAID BY RECEIPT: R3791 $89.00 CM OF ATLANTIC BEACH 800 SE14NOLE RD ATLANTIC BEAC,HE 32233 1214,12017 16:26:51 CREDIT CARD VISA SALE Cad# k2=0=6701 SEQ A: 6 Bal 511 INVOICE 6 Approval Code: 075548 Eno I*W: MIMI Modx: 011111A Tax knourt: $0.00 Out Codx: Cad CA: M SALE AMOUNT oz CUSTOMER COPY Date Paid:Thursday, December 28, 2017 Paid By:SAWYER GAS OF THE BEACHES Cashier: BA Pay Method: CREDIT CARD 6 Printed:Thursday,December 28,2017 4:27 PM 1 of 1