1251 Selva Marina Dr gas permit 1.SS CITY OF ATLANTIC BEACH
"P,
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
MECHANICAL RESIDENTIAL GAS -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: GSRS18-0035
Description: install 3 gas-piping outlets, 2 water heaters, 250-gal. tank
Estimated Value: 1232
Issue Date: 4/12/2018
Expiration Date: 10/9/2018
PROPERTY ADDRESS:
Address: 1251 SELVA MARINA CIR
RE Number: 1719130000
PROPERTY OWNER:
Name: BUDNICK TODD S
Address: 370 12TH ST
ATLANTIC BEACH, FL 32233-5437
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: AEI INTERNATIONAL CORP.
Address: 7709 ALTON AVE QA LEWIS SPRADLIN
JACKSONVILLE, FL 32211
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.
NOTICE: In addition to the requirements of this permit, there may be additional restrictions
applicable to this property that may be found in the public records of this county, and there may
be additional permits required from other governmental entities such as water management
districts, state agencies, or federal agencies.
* 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.
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CffY OF ATLANTic BFAcH
goo Seminole Rd Atlaafic B=h, FL 32233
Ph(904)247-5826 Fax(904)24.7-5845 CIS V 's I o0zS..
IoRAwmEss: 1251 Selvo- HarinO� �,r PERbUr#
PROJECT VALUE $ 1232.00 A" REQUIRED
Air Handling Equipment 0.nly Air Handling Unit Condenser Condenser Only
�CEW 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
UPLACEMIENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning; Unit Quantity Tons Per Unit
Heat. Unit Quantity BTILT's Per Unit Seer Rating-
Duct Systeins: Total CFM REQUMED.
�XRE 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 Quan-dty (Requkes 3 sets of plans)
Fire Suppression Systerns Quantity (Requires 3 sets of plans)
711RE PLACES I%USCELLANEOUS-.
Prefabricated Fireplace QtY Automobile Lifts
Gas Piping 0aflets Boilers BTU's
Elevators/Escalators
U,L OTHER GAS PIEPING Heat Exchanger
Quantity of Outlets Pumps
A Vented Wall Furnaces Refrigerator Condenser BTU's
4 Water Heaters Solar Collection Systeins
Tanks (gallons) 7-50 Qaj
Wells
ra
)THER: Crks jn (2) PW heotv- ana Vwwox�
crmit becomcs void If work docs not commoncz within a sixzuonth p�Tiod or w6rk is suspzad-,d or abgmaoned for six months.14meby cerffy that I have rea
us application and know the same to bc tnx and wrrwt All provisions of laws and ordinancos gov=ing this work will be oomli,�,d with whether spwixic�i
ot. The permit does not give authority to violate the provisions of any otha"c or local law reguladon consuuction or the performance of constmcdon.
troperry Owners Name ELLStern Shore,,� ConStrucfion phone Numbor 5L15 4�5 lb
Aechanical Company ClaS
PEL11A C01-�LdI22-- jCe, Office Phone7m-1-1-11 Fax -7 2.1-3-e>�
"o, Address: -7-109 A ve- C d2,&,�6o0vik Statef-L, Zip3ZL:�Ll_
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,icense Holder(Print): &jjk�).C6 Sj2AJ jj'rj Stat Cerqcation/Registration#
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SIEPHAI-41E E.CARTER t') 4f ,I
NOt2ry PubliG-SWO Of F100da Before -his-, day of 20
Commission # FF 141288 Signature of Notary Public
Me I
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my coijim.Expifes Jul 13,2015
SuRded Thro*Natimal Notwv Assn.
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Cash Register Receipt Receipt Number
City of Atlantic Beach R4764
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $99.00
GSRS18-0035 Address: 1251 SELVA MARINA CIR APN: 171913 0000 $99.00
MECHANICAL $95.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
GAS PIPING OUTLETS 455-0000-322-1000 3 $10.00
TANKS GAS OR LIQUEFIED PETROLEUM 455-0000-322-1000 250 $20.00
VENTED WALL FURNACE WATER HEATER 455-0000-322-1000 2 $10.00
UNIT
STATESURCHARGES $4.00
STATE DBPR SURCHARGE 455-0000-208-0600 0 $2.00
STATE DCA SURCHARGE 45500002080700 0 $2.00
TOTAL FEES PAID BY RECEIPT: R4764 $99.00
CITY OF ATLANTIC BEACH
800 SEMINOLE RD
ATLANTIC BEAC,FL 32233
04/12/2018 15:42:44
CREDIT CARD
VISA SALE
Card# XXXXXX=2786
SEQ#: 11
Bath#: 583
INVOICE 11
Approval Code: 012626
Entry Method: Manual
Mode: Online
Tax knount: $0.00
Card Code: M
SALE AMOUNT
CUSTOMER COPY
Date Paid:Thursday, April 12, 2018
Paid By: AEI INTERNATIONAL CORP.
Cashier: BA
Pay Method: CREDIT CARD 11
Printed:Thursday,April 12,2018 3:43 PM 1 of 1
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