1883 Atlantic Beach Dr HVAC permit �N .
CITY OF ATLANTIC BEACH
.r g1
.w 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: ACRS18-0018
Description: install 5-ton 60K-BTU AHU
Estimated Value: 9450
Issue Date: 1/16/2018
Expiration Date: 7/15/2018
PROPERTY ADDRESS:
Address: 1883 ATLANTIC BEACH DR
RE Number:
PROPERTY OWNER:
Name: RIVERSIDE HOMES OF N FL
Address: 414 OLD HARD RD STE 502MATTHEW ROBERTS
ORANGE PARK, FL 32003
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: A/C MASTERS HVAC INC
Address: 11243 ST JOHNS PKWY APT 3 QA CHARLES STEVEN
CRABTREE
JACKSONVILLE, FL 32246
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$7,500.
MECHANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233
�J n Phi(904)247-5826 Fax(904)247-5845 S I
JOB ADDRESS: f 0 i���4 n t c. Ea�� r �Y PERMrr# n',�I t 33 3?
PROJECT VALUE$
NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity I Tons Per Unit
Heat: Unit Quantity---T — BTU's Per Unit 1 Seer Rating_
Duct Systems: Total CFM –a--RT ` REQUIRED
REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity Tons Per Unit ARI# QE U–R D
Heat: Unit Quantity BTU's Per Unit Seer Rating_
Duct Systems: Total CFM REQUIRE)}
.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:
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 violatedieprovisions of any other state or local law regulation construction or the performance of construction.
Property Owners Nalene 4I m e s Phone Number
Mechanical Company A C Ptt I� x �� Office Phone 7 j) -M S� Fax 7,)1 2 yy
Co.Address: `7 v1 J �rts ria . a2 � 306 City c State L Zip
License Holder(Print)- S, C�+�� rc S C cation/Registration# C�
Notarized Signature of License Holder
DEBRA ANN HOISMGTON Sworn and subscribed before m this 6 Of 1 a 4 �.✓ 20 y
' MY C(7MMISSION Y GQ031926 Signature Of Notary Public
EXPIRES Oclobar 15,2020
I
S rS�illj�
Cash Register Receipt Receipt Number
City of
DESCRIPTION • QTY PAID
PermitTRAK $147.15
ACRS18-0018 Address: 1883 ATLANTIC BEACH DR APN: $147.15
MECHANICAL $143.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
Imo_
AC AND REFRIGERATION 455-0000-322-1000 5 $40.00
AIR DUCT SYSTEM 455-0000-322-1000 2000 $20.00
FURNACES AND HEATING 455-0000-322-1000 60000 $28.00
STATE SURCHARGES $4.15
STATE DBPR SURCHARGE 455-0000-208-0600 0 $2.15
STATE DCA SURCHARGE 45500002080700 0 $2.00
TOTALBY RECEIPT: R3937 $147.15
Date Paid: Tuesday, January 16, 2018
Paid By: A/C MASTERS HVAC INC
Cashier: CB
Pay Method: CREDIT CARD 08748G
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Printed:Tuesday,January 16, 2018 1:01 PM 1 of 1
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