1769 Atlantic Beach Dr gas permit f 11byr
11=J 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: GSRS18-0056
Description: install 4 gas-piping outlets &water heater
Estimated Value: 1900
Issue Date: 5/21/2018
Expiration Date: 11/17/2018
PROPERTY ADDRESS:
Address: 1769 ATLANTIC BEACH DR
RE Number: 169505 1475
PROPERTY OWNER:
Name: ADCOCK BRIAN J
Address: 14560 ISLAND DR
JACKSONVILLE, FL 32250
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.
09/03/2011 10:17 9047213350 AEIGAS PAGE 01/01
MECHANICAL PERMIT APPLICATION
--''- CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233 �
Ph(904) 247-5826 Fax(904)247-5845 �*5
JOR.ADDRESS: l 1 1 � ' G �aC�'�� l�C. PERMIT#
,PROJECT VALUE $ 1 I)P cPo 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: -rotas 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 __a_ Pumps
# Vented Wall Furnaces Refrigerator Condenser BTU's
# Water Heaters Solar Collection Systems
Tanks (gallons)
Wells
OTHER: o.QwA 40 �kr4cu,a.
Permit becomes void if work docs not commence within a six month pe iod oA work s suspended or abandoned for six months.1 hereby certify that t have read
this application and know the sante to he true and correct. All provisions of law-,and ordinances governing this work will be complied with whether specked or
not. The permit does not give auth��orritty,,to violatc d,c provisions of atiy-otther state or local law regulation consmiction or the performance of construction. _
Property Owners Nairne t_f 6' �J4A0Q0)*-A -- Phone Number �,�315
Mechanical Company ��` �l�Vr7 O�1DQ1yCoyt��ffice Phone ���Fax�lr �
Co. Address:"I~1 OCA A kkon G � City nV14,a _State V Zip
License Holder (Print): f!A Cha- j', Md l i n State Certification/Registration# '
n _ _a der
PHANIE E.CARTER Iq
�� �•= Notary Public-state of Florida Before nye this �� day of 20
• My Comm.Eacplras Jul 11, a
Cortrml3slon rr ff 141288 , ignature of Notary Public
' �"•• t�on W WnuM Natlonal Notary Assn.
f
Cash Register Receipt Receipt Number
City of Atlantic Beach • •
DESCRIPTION • CITY PAID
PermitTRAK $74.00
GSRS18-0056 Address: 1769 ATLANTIC BEACH DR APN: 169505 1475 $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
UNIT 455-0000-322-1000 1 $5.00
STATE SURCHARGES $4.00
STATE DBPR SURCHARGE 455-0000-208-0600 0 $2.00
STATE DCA SURCHARGE 1 45500002080700 1 0 $2.00
'TOTALPAID BY RECEIPT: •
11
CITY OF ATIANTIC BEACH
800 SEMINOLE RD
ATLANTIC BEAC,FL 32233
05 21;2018 09:22:45
CREDIT CARD
VISI;SALE
Card a XWXXXX W2786
SEQ u: 2
Batch;: 610
INVOICE 2
Approval Code: 021651
Entry Method: Manual
Mode: Online
Tax Amount: $0,00
Card Code: M
SALE AMOUNT $74,�
CUSTOMER COPY
Date Paid: Monday, May 21, 2018
Paid By: AEI INTERNATIONAL CORP.
Cashier: BA
Pay Method: CREDIT CARD 2
Printed: Monday, May 21,2018 9:23 AM 1 of 1
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