1760 SELVA MARINA DR - GAS 1r' ' � CITY OF ATLANTIC BEACH
J ,,iz. ,,: , p 800 SEMINOLE ROAD
,� ______„9
ATLANTIC BEACH, FL 32233
r . 9INSPECTION PHONE LINE 247-5814
MECHANICAL RESIDENTIAL GAS -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: GSRS18-0044
Description: GAS PIPING-ONE OUTLET AND A 250 GAL TANK
Estimated Value: 0
Issue Date: 4/30/2018
Expiration Date: 10/27/2018
PROPERTY ADDRESS:
Address: 1760 SELVA MARINA DR
RE Number: 172009 0000
PROPERTY OWNER:
Name: LAURA L FERRANTE LIVING TRUST
Address: 1760 SELVA MARINA DR
ATLANTIC BEACH, FL 32233-5618
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
,
Phone:
Name: SUBURBAN PROPANE L.P.
Address: 45 S DIXIE HWY
ST AUGUSTINE, FL 32084
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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•
Number
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Cash Register ReceiptReceipt
• City of Atlantic Beach R4922
DESCRIPTION I ACCOUNT QTY PAID
PermitTRAK $89.00
GSRS18-0044 Address: 1760 SELVA MARINA DR APN: 172009 0000 $89.00
MECHANICAL $85.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
TANKS GAS OR LIQUEFIED PETROLEUM 455-0000-322-1000 250 $20.00
GAS PIPING OUTLETS 455-0000-322-1000 1 $10.00
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: R4922 $89.00
CITY OF ATLANTIC BEACH
800 SEMINOLE RD
ATLANTIC BEAC,FL 32233
04:30,2018 09:48:48
CREDIT CARD
MC SALE
Card; XXXXXXXXXXXX2862
SEQ n; 4
Batch;: 595
INVOICE 4
Approval Code: 030971
Entry Method: Manual
Mode: Online
Tax Amount: $0.00
Cust Code:
Card Code: M
SALE AMOUNT S89,00
CUSTOMER COPY
Date Paid: Monday, April 30, 2018
Paid By: FERRANTE LAURA L
Cashier: BA
Pay Method: CREDIT CARD 4
Ote
Printed: Monday,April 30,2018 9:50 AM 1 of 1
1RAIGT
MECHANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904)247-5826 Fax(904)247-5845 C SR S 18- Q o 41-
JOB ADDRESS: «u 0 5 G J is riodziNA t 333 PERMIT#
PROJECT VALUE$ i'-.1 15 • O 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
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 l - Pumps
#Vented Wall Furnaces Refrigerator Condenser BTU's
# Water Heaters Solar Collection Systems
Tanks (gallons) 0150 (,161 TA f•A4-,
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 violate the provisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name L.,4 lit R t4 e y.(.Z A tJ 1 Phone Number
Mechanical Company S`vt to idur 10041 R-0 pod\ Office Phone 8?11-5'23Fax 8.2/- /3 44
Co.Address: y C5 5 . ;Olio i4A,,/A( 3\ AUy 3Z0 gCity 5�'. AvtL-, State E L- Zip 37-0 �
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License Holder(Print): l)I1�/1 b (z4 (� State Certification/Registration# 0 / SG.5
No - • •r •, 1 , • • _ 1 • : ,!der, / ,4.k
"IN. =Olio state a Honda
Gbria R swantt :efore me this 49 day of /MX) L 20 l g
ilr ,0313 on G 19473a
Signature of Notary Public G. ,,k,esx4(....k—,
MAP SHOWING SURVEY OF ��
LOT 9, BLOCK 9, SELVA MARINA UNIT NO. 5, AS RECORDED IN PLAT BOOK 30, PAGES ?
S
! 29 AND 29A OF TNk CURRENT PUBLIC RECORDS OF DUVAL COUNTY, FLORIDA,
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I, I hereby noritty that this survey meets the
minImum technical standards as set torah by
Ms Florida Board rot Land Surveyors,pursuant
11. A. O�irOrN to Section 472.07 Florida Statutes .!
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THIS SURVEY NOT VALID UNLESS THIS PRINT IC EUBOOSED WITH THE SEAL OF TUE ABOVE SIGHED.
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