1855 Hickory ACRS18-0431 MECHANICAL RESIDENTIAL HVAC PERMITNUMBER
PERMIT ACRS18-0431
ISSUED:
CITY OF ATLANTIC BEACH EXPIRES,
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
i5m.1yau—
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
NOTICE: In addition to the requirements of this permit,there may be additional restrictions applicable to this property
S pro
that may be found in the public records of this county,and there may be additional permits required f am other
7governmental entities such as water management districts,state agencies,or federal agencies.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
1855 HICKORY LN MECHANICAL RESIDENTIAL 3 Ton 34.8K BTU HVAC Unit $4367.97
HVAC
TYPE OF REALESTATF ZONING: BUILDING USE
CONSTRUCTION: NUMBER: GROUP: SUBDIVISION:
1720201434 SELVA MARINA UNIT
12C R/P
COMPANY ADDRESS: CITY: STATE: ZIP:
WAYCHOFFSAIR
CONDITIONING 6929 5 PHILLIPS PARKWAY DR JACKSONVILLE FL 32256
OWNER: ADDRESS: CITY: STATE: ZIP:
MAIN EDNA DEWEY 1855 HICKORY UN ATLANTIC BEACH FL 32233
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT
IN YOUR 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 ORAN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
LIST OF CONDITIONS
�-Il off container companymust be on City approved list. Containercinnot be placed on City rlght�of-way.
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
AC AND REFRIGERATION 455-0000�322 1000 3 $24.00
FURNACES AND HEATING 4SS-00�322 1000 3LBOO $24.00
MECHANICAL BASE FEE 455�322-1000 0 $55.oa
STATE DBPR IU�RCW6E
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MECHANICAL RESIDENTIAL HVAC PERMIT NUMBER
PERMIT ACRS18-0431
ISSUED:
EXPIRES:
CITY OF ATLANTIC BEACH
208� 52.00
TOTAL:
Imed Date: 2 of 2
Cash Register Receipt Receipt Number
City of Atlantic Beach R7038
DESCRIPTION ACCOUNT QTY PAID
PermItTRAK $107.00
ACRS18-0431 Address: 1855 HICKORY LN APN: 172020 1434 $107.00
MECHANICAL $103.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55�00
AC AND REFRIGERATION 455-0000-322-1000 3 $24.00
FURNACESAND HEATING 455-0000-322-1000 34800 $Z4 00
STATIE SURCHUNiIES $4.00
STATE DBPR SURCHARGE 455-0000-208-0�700 � $2.00
STATE DCA SU RCHARG E 455-0000-208- 600 $2.00
TOTAL FEES PAID BY RECEIPT: R7038 $107.00
Date Paid:Friday, October 12, 2018
Paid By:WAYCHOFFS AIR CONDITIONING
Cashier: BA
Pay Method: CREDIT CARD 8
Printed:Friday,October 12,2018 4:04 PM 1 of 1
MECHANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beech,FL 32233
Ph(904)247-5826 Fax(904)247-5845
JOBADDRESS: kR<,S lAievvyA Ln. PEPIVUT#W—
PROJECT VALUE ARr# q (01'10T-J REQUIRED
_.Air Handling Equipment Only ___Air Handling Unit& Condenser —CondenserOnly
NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity SL 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 I'L Tom Per Unit. 1-5
Heat: Unit Quantity rL BTU's Per Unit bti.?, ScerRatiniz �9-5D--
T—
Duct Systems: Total CFM REQU RED
FIRE PREVENTION
Fire Sprinkler System Quantity (Requires 3 sets of plans)
Fire Standpipe Quantity (Requires 3 sets of plans)
Underground Fire Main Value quires 3 sets of plans)
'c
Fire Hose Cabinets Quantity (Require:3::ts of plans)
( aq
Commercial Hoods Quantity 3 ts of plans)
Fin Suppression Systems Quantity (Requires 3 sets of plans)
FIRE PLACES MISCELLANEOUS:
Prefabricated Fireplace Qty_ Automobile Lifts
Gas Piping Outlets Boilers — BTU's
Flevators/Escalators
ALL OTHER GAS PIPING Heat Fxchanger
Quantity of Outlets Pumps
#Vented Wall Fumaces Refrigerator Condenser ETU
#Water Heaters Solar Collection Systems
Tanks(gallons)
Wells
OTHER:
or work Is suspended or abandoned for six months.I hereby cent that I haw mad
Permit becomes said if work does not mosence within a six month period r specified or
this application and know the same to be true and coned. All prosisions,of lam and ordinances governing this work will be compiled with whethe
not, The permit does not give authority to violate the provisions of my other state or local loor regulation construction or the performance ofconstraction.
Property O�ners Name �N Phone Numberiaq-1)o3-`?oo(P
Mechanical Company mmv\c) ffice PhoneZk:LT25 Fao:Aa��
\j
Co. Address: City3,C�,jikSL StmeELZip
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License Holder(Print): ON, V\Ak Smnification/Registration#CAVS138")
Notarized Signature of License Holder
Before me this P'll, day of 2016—
I NoWar P,r,c mats 01 Fla
F cintron tary Public
MyCo svorGG179303 Signart==of NO
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