GSRS18-0053 INVOICE N
Jtl ` City of Atlantic Beach INV-4141
Alf t' 800 Seminole Road Date Due: 6/16/2018
Atlantic Beach, FL, 32233
- REPRINT -
CONSTRUCTION SOLUTIONS&
5225 EDGEWOOD Cr
SUPPLY 1041 FOX MEADOW TR
JIM ROMEKA,JA FL
Invoice Date:5/17/2018
Fee Group Fee Description QuantityQuantitym
Amount Paid Receipt
Record# Record Type
GSRS38-0 53 MECHANICAL RESIDENTIAL MECHANICAL GD�iI G 4 $30.00 $10.00 85111
GAS
ETS
MECHANICAL BASE 0 $55.00 $55.00 R5111
FEE
VENTEDWALL 1 $5.00 $5.00 R5111
FURNACEWATER
HEATER UNIT
STATE SURCHARGES STATE DBPR 0 $2.00 $2.00 85131
SURCHARGE
STATE DCA 0 $2.00 $2.00 RS111
SURCHARGE
$74.00
Invoice Total:$74.00
Payment Summary:
Payment Method Paid Amount Receipt#
$�q.pp
CREDIT CARD R5111
Total Paid: $74.00
Total Due: $0.00
Please send your payment to this address:
Printed:Wednesday,lune 13,2018 11:59 AM 1 of I
;Aj "
h 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: GSRS18-0053
Description: install 4 gas-piping outlets &water heater
Estimated Value: 1135
Issue Date: 5/18/2018
Expiration Date: 11/14/2018
PROPERTY ADDRESS:
Address: 1614 MARITIME OAK DR
RE Number: 169505 1960
PROPERTY OWNER:
Name: BARBIERI ROBERT FRANCIS
Address: 2659 BAMBY LN NE
ATLANTA, GA 30319
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: CONSTRUCTION SOLUTIONS &
Address: 5225 EDGEWOOD CT SUPPLY 1041 FOX MEADOW TRIJIM
ROMEKA
JACKSONVILLE, FL 32254
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.
MECHANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
X) 800 Seminole Rd Atlantic Beach, FL 32233
Ph(904) 247-5826 Fax (904) 247-5845 C S(L S( 7— con
OB ADDRESS: 1-33 A-�J o v,�r c- b eaC�k Co c kJrt-, CL u In PERMIT#
PROJECT VALUE $ l,l 3 5. a ARI# REQUIRED
Air Handling Equipment Only Air Handling Unit & Condenser Condenser Only
1EW 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
MPLACEMENT 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
IRE 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)
TIRE PLACES MISCELLANEOUS:
Prefabricated Fireplace Qty Automobile Lifts
Gas Piping Outlets �_ Boilers BTU's
Elevators/Escalators
iLL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets 3 Pumps
#Vented Wall Furnaces Refrigerator Condenser BTU's
#Water Heaters ✓ Solar Collection Systems
1 Lav, a► ✓ Tanks (gallons)
1 "P 4- ✓ Wells
)THER:
ermit 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
lis 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
ot. The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of construction.
'roperty Owners Name 514 DO—s. Phone Number 90q- 331- 11X(0
90 y
Iechanical Company n 'a\50 u��r.a ns Office Phone 3$9—X7 od Fax
;o. Address: r� -II S 1rd,ywoo6 C X. City -1or-ksvh u I(1•e. State Zip 32A5
,icense Holder(Print): K r- f'jr 0,^ State Certification/Registration# Z4 4 S 7
Jotarized Signature of License Holder
Before me this 1��day of M 20 1
E,-*
!e`. Notary Public State of Floods
Judy A Wilkersonfav My Commission FF 974411Signature of Notary Publico Expires 05/02/2020 w j� So✓1
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