379 SKATE RD DUCTS 11 is 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: MCRS18-0004
Description: ADD 4 SUPPLY DUCTS TO NEW ROOM ADDITION
Estimated Value: 1000
Issue Date: 4/13/2018
Expiration Date: 10/10/2018
PROPERTY ADDRESS:
Address: 379 SKATE RD
RE Number: 171671 0000
PROPERTY OWNER:
Name: Ty Bliss
Address: 379 Skate Road
ATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: ANGLER HEATING &AIR INC.
Address: 4533 SUNBEAM RD SUITE 403 QA ELLIOTT, BERNARD VANE
III
JACKSONVILLE, FL 32257
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.
S�
Cash
r Register
City of Atlantic Beach • •
DESCRIPTION • CITY PAID
PermitTRAK $79.00
MCRS18-0004 Address: 379 SKATE RD APN: 1716710000 $79.00
MECHANICAL $75.00
AIR DUCT SYSTEM 455-0000-322-1000 350 $20.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
STATE SURCHARGES $4.00
STATE DBPR SURCHARGE 455-0000-208-0600 0 $2.00
STATE DCA SURCHARGE 45500002080700 0 $2.00
TOTALR4778 $79.00
-7
Q o A C
_O
n
3 m Nrrr
n
v rte' rrn n
N �O
o CO
3 0 7b a o m p N
a
Date Paid: Friday, April 13, 2018
Paid By: ANGLER HEATING & AIR INC.
Cashier: CB
Pay Method: CREDIT CARD 000946
Printed: Friday,April 13,2018 4:50 PM 1 of 1
MECHANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233 Q'
Ph(904) 247-5826 Fax (904)247-5845 G �D
l
JOB ADDRESS: J {� A+ C�� 1 c h . PERlv>�r# 1�" - Z
PROJECT VAL UE S / °��� ARI# REQUIRED
Air Handling Equipment Only Air Handling Unit & Condenser Condenser Only
NEW 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
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
Manual J documentation required on residential change out
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: 4c ;s e lam'e
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 NameT�/ y t S S Phone Number g3 Y— L(r 3
Mechanical Company /%�v Q /n Ne 4 t, ,�;r Office Phone Z/11-i Z`/0 Fax
Co. Address: Z a; City j"!W. State tC( Zip 3 Z Z 4-7
License Holder(Print): State Certification/Registration# CLQ S 7 6.6
Notarized Signature of License Holderzz�
REBECCA ANN RAY Before me this
1
MY COMMISSION X GG 071215
EXPIRES:March 6,2021Signature of Notary Pu
%E2,Ft°.pj' sordes nm,Nary PW*L*xW +x rs