1855 MAYPORT RD - HVAC .Alific, MECHANICAL RESIDENTIAL HVAC PERMIT NUMBER
" ACRS18-0459
��► PERMIT ISSUED:
,`C.i„ CITY OF ATLANTIC BEACH EXPIRES:
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORM TO THE CURRENT 6TH EDITION (2017) OF THE FLORIDA BUILDING
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
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.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
1855 MAYPORT RD MECHANICAL RESIDENTIAL HVAC - 1 A/C, 1 AHU, 3 TON $4600.00
HVAC
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
172047 0010 SECTION LAND
COMPANY: ADDRESS: CITY: STATE: ZIP:
BOLD CITY HEATING AND
AIR INC 837 Mendoza Drive Jacksonville FL 32217
OWNER: ADDRESS: CITY: STATE: ZIP:
LAW OFFICES OF JASON A 1855 MAYPORT RD ATLANTIC BEACH FL 32233
BURGESS LLC
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT
IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST
INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
LIST OF CONDITIONS
Roll off container company must be on City approved list. Container cannot be placed on City right-of-way.
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
TOTAL:
Issued Date: 1 of 1
NMechanical Permit Application **ALL INFORMATION
SI'.41411A) City of Atlantic Beach BuildingDepartment
HIGHLIGHTED GRAY
E
p GRAY IS REQUIRED.
800 Seminole Rd,Atlantic Beach, FL 32233
44r.)loovPhone: (904) 247-5826 Email:Building-Dept@coab.usP\C R S t
PERMIT#: 8 -04S
JOB ADDRESS: 1855 Mayport Rd PROJECT VALUE$a.600•00
❑NEW AIR CONDITIONING&HEATING SYSTEM INSTALLATION ARI#(REQUIRED)
0 Air Handling Equipment Only ❑Condenser Only 0 Air Handling Unit&Condenser
Air Conditioning: Unit Quantity Tons per Unit
Heat: Unit Quantity BTUs per Unit Seer Rating(REQUIRED)
Duct Systems: Total CFM
[]✓ REPLACEMENT AIR CONDITIONING&HEATING SYSTEM INSTALLATION AR!#(REQUIRED)
❑Air Handling Equipment Only ❑Condenser Only p Air Handling Unit&Condenser
Air Conditioning: Unit Quantity 1 Tons per Unit 3.0
Heat: Unit Quantity 1 BTU's Per Unit 36,000 Seer Rating(REQUIRED) 14.00
Duct Systems: Total CFM
❑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 D MISCELLANEOUS:
Prefabricated Fireplace(Qty) Automobile Lifts
Gas Piping Outlets Boilers BTUs
Elevators/Escalators
❑ALL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets Pumps
#Vented Wall Furnaces Refrigerator Condenser BTUs
#Water Heaters Solar Collection Systems
Tanks(gallons)
Wells
aOTHER:
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.
Owner Name:Jason Burgess Phone Number
Mechanical Company:Bold City Heating and Air Office Phone:(904)379-1648 Fax
Co.Address:8900 Philips Highway,Suite 52 City:Jax State:FL Zip:32216
License Holder: Mirza Pilakovic Sta r'Prtjfication/Registration#
Notarized Signature of License Holder
The foregoing strumflht was acknowledged before me this `' day of �-9r% 20_1,in the State of Florida,
County of ( Uv t,A
Signature of Notary Public __,___-- r
Akk"' EMINA PILAKOVIC (1Personally Known OR[ )Produced Identification
,k MY COMMISSION I GG0867 ype of Identification:
EXPIRES March 26.2021
Updated 10/9/18
P.eCash Register Receipt Receipt Number
City of Atlantic Beach R7314
DESCRIPTION I ACCOUNT QTY PAID
PermitTRAK $107.00
ACRS18-0459 Address: 1855 MAYPORT RD APN: 172047 0010 $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
FURNACES AND HEATING 455-0000-322-1000 36000 $24.00
STATE SURCHARGES $4.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL FEES PAID BY RECEIPT: R7314 $107.00
CI,'Y OF ATLANTIC BEACH
800 SENINOLE RD
ATLANTIC LAC,FL 32233
11 09 2018 10:42:51
CREDIT CARD
VIS/SALE
Card XXXXXXXXXXXX8351
SEQ;: 1
Batch n: 730
INVOICE 1
Approval Code: 005271
Entry Method: Manual
Mode: Online
Tax Amount: $0.00
Card Code: M
SALE AMOUNT $107,00
CUSTOMER COPY
Date Paid: Friday, November 09, 2018
Paid By: BOLD CITY HEATING AND AIR INC
Cashier: BA
Pay Method: CREDIT CARD 1
Printed: Friday, November 09,2018 10:43 AM 1 of 1
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