765 PLAZA HVAC \SS CITY OF ATLANTIC BEACH
'r- -•r f' 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: ACRS18-0378
Description: 2.5 Ton 30K BTU Unit
Estimated Value: 4000
Issue Date: 8/30/2018
Expiration Date: 2/26/2019
PROPERTY ADDRESS:
Address: 765 PLAZA
RE Number: 171119 0000
PROPERTY OWNER:
Name: FORNEY RALPH J
Address: 765 PLAZA
ATLANTIC BEACH, FL 32233-3907
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: ISLAND HEATING AND AC
Address: 1146 Hamlet Court William G. Noe Ill
Neptune Beach, FL 32266
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
800 Seminole Rd Atlantic Beach, FL 32233
Ph (904)247-5826 Fax (904) 247-5845 '�Q�-�s ^�JOB ADDRESS: / S ��ct Z�. 12 PERMIT PIS�0 V d
PROJECT VALUE $ LI, o o t . .-IRI# 96 g i REQUIRED
Air Handling Equipment Only Handling Unit & Condenser Condenser Only
NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity Tons Per Unit
I-Teat: 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 g, rJ
Heat: Unit Quantity I BTU's Per Unit 3o oc ci Seer Rating ) `'1 .0
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 Pumps
# Vented Wall Furnaces — Refrigerator Condenser BTU's
# Water Heaters 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 tiff six months. I hereby certify that I have read
this application and know the same to he true and correct. All provisions of laws and ordinances governing this work will he 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 T .G.l Ph Gfekt.1 Phone Number 6 f!o - 00 (
Mechanical Company c 14.211� ,41J Az Office Phone333i 7yq Fax
Co. Address: //`fir; Nt,:'i,1 .J c` City NAik,e_ State c-C- Zip 3226(
License Holder(Print): adid . lSA/� -- State Certification/Registration # (4x.1$17 Coe,
Notarized Signature of License Holder
- Before me this .50 day of e g(..,(5 20 1 S
i HEATHER DANIELLE BURRELL
t. ,��: MY COMMISSION JIFF 977518 Signature of Notary Public
a;,�`�-; EXPIRES:Aptil 11,2020
'i*.�f�Q�.•gwidod Thiu Nasty pubic undowftters