2303 Fiddlers Ln gas piping permit CITY OF ATLANTIC BEACH
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: GSRS18-0041
Description: install 4 gas-piping outlets &one water heater
Estimated Value: 2500
Issue Date: 4/19/2018
Expiration Date: 10/16/2018
PROPERTY ADDRESS:
Address: 2303 FIDDLERS LN
RE Number: 169463 0126
PROPERTY OWNER:
Name: EBERT WILLIAM P J
Address: 2303 FIDDLERS LN
ATLANTIC BEACH, FL 32233-4681
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: FLORIDA PROPANE PARTNERS
Address: 461 TRESCA RD DEWEY FLOWERS
JACKSONVILLE, FL 32225
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.
Apr, 18- 2018 3 ; 39PM No, 5540 P. 1
MECHANICAL PERMIT APPLICATION
CITY oiF ATLANTIC ]BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904)247-5826 Fax (904) 247-5845 �� .S OCDL(f
Joie ADDRESS: J.� U 3 F 10 iXEG LK) PERMIT#
PROJECTVAL SIE $ 15" ARr# 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
FIRE PREVENTION
Fire Sprinkler System Quantity (Requires 3 sets of plans)
Fire Standpipe Quantity (Requires 3 sets of playas)
Underground Fire Main Value (Requires 3 sets of plans)
Fire Hose Cabinets Quantity (Requires 3 sets of playas)
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
Oras Piping Outlets �, Boilers BTU's ,
Elevators/Escalators
ALL OTHER GAS PIPING Neat Exchanger
Quantity of Outlets Pumps
#Vented Wall Furnaces Refrigerator Condenser BTU's
#Water Heaters I 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,l hereby certify that l 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 J0 8 0 F650T(W Phone Nuixlber y0cl C(-1 k fC b
Mechanical Company F090 M0PA0e PPrV1XIZs 013A L-K FIS Office Phone `I3 ;Fax
CAPS
Co, Address- y1 )�r) City TACKSWNV)t U State F_Zip
License b1 "7bmary
4� q • �U ► �U• tate Certificatio ' ation#
NotarizXV Sitee of Liceri�e Alder .�
MM Expires: � � '�[J
1B,2021 = iefpre m is 1 f� d f 20
k No.Ota 74059
��N�jti•pt/6L��•��;�O�'ti Signature f Notary public :?``` r
4?S
Cash Register Receipt Receipt Number
City of Atlantic Beach R4830
DESCRIPTION • QTY PAID
PermitTRAK $74.00
GSRS18-0041 Address: 2303 FIDDLERS LN APN: 169463 0126 $74.00
MECHANICAL $70.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
GAS PIPING OUTLETS 455-0000-322-1000 4 $10.00
VENTED WALL FURNACE WATER HEATER 455-0000-322-1000 1 $5.00
UNIT
STATE SURCHARGES $4.00
STATE DBPR SURCHARGE 455-0000-208-0600 0 $2.00
STATE DCA SURCHARGE 45500002080700 0 $2.00
TOTAL FEES PAID BY RECEIPT: R4830 $74.00
CITY OF ATLANTIC BEACH
800 SEMINOLE RD
ATLANTIC BEAC,FL 32233
04/19 2018 11:25:21
CREDIT CARD
VISA SALE
Card XXXXXYXXXXXX5100
SEQ u: 3
Batch u; 588
INVOICE 3
Approval Code: 05634G
Entry Method: Manual
Mode: Onlhe
Tax Amount: $0.00
Card Code: M
SAIF AMOUNT 6742
CUSTOMER COPY
Date Paid:Thursday, April 19, 2018
Paid By: FLORIDA PROPANE PARTNERS
Cashier: BA
Pay Method: CREDIT CARD 3
Printed:Thursday,April 19,2018 11:26 AM 1 of 1
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