318 SEMINOLE RD - GAS - -/-1-- f.4, MECHANICAL RESIDENTIAL GAS PERMIT NUMBER I
v S,
PERMIT GSRS18-0114
).v,,,,_ ) ISSUED: 11/14/2018
, �.i��; CITY OF ATLANTIC BEACH EXPIRES: 5/13/2019
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:
318 SEMINOLE RD MECHANICAL RESIDENTIAL GAS Outlets & Tank for Gas $2500.00
Piping
TYPE OF REAL ESTATE { ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
170431 0018 SALTAIR SEC 02
COMPANY: ADDRESS: CITY: STATE: ZIP:
WESTERN NATURAL GAS 2960 STRICKLAND ST JACKSONVILLE FL 32205
COMPANY
OWNER: ADDRESS: CITY: STATE: ZIP:
Speranzi Craig 318 Seminole Road 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 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
GAS PIPING OUTLETS 455-0000-322-1000 3 $10.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TANKS GAS OR LIQUEFIED PETROLEUM 455-0000-322-1000 120 $20.00
Issued Date: 11/14/2018 1 of 2
MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
PERMIT GSRS18-0114
-1.015:2
ISSUED: 11/14/2018
CITY OF ATLANTIC BEACH EXPIRES: 5/13/2019
TOTAL:$89.00
Issued Date: 11/14/2018 2 of 2
f �p� Mechanical Permit Application "`ALL INFORMATION
HIGHLIGHTED IN
ry + City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 s/$- o z c
PP Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: SKS/R- it
JOB ADDRESS: � Pit'AC.>r d PROJECT VALUE$ c5-0?,(17)
❑NEW AIR CONDITIONING &HEATING SYSTEM INSTALLATION AR!#(REQUIRED)
❑Air Handling Equipment Only 0 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 0 Condenser Only In Air Handling Unit& Condenser
Air Conditioning: Unit Quantity Tons per Unit
Heat: Unit Quantity BTU's Per Unit Seer Rating(REQUIRED)
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 El MISCELLANEOUS:
Prefabricated Fireplace(Qty) Automobile Lifts
Gas Piping Outlets / Boilers BTUs
Elevators/Escalators
EAU OTHER GAS PIPING Heat Exchanger
Quantity of Outlets Pumps
#Vented Wall Furnaces Refrigerator Condenser BTUs
#W ter Heaters / Solar Collection Systems
/LLc.4-q e- I banks(gallons) /b0
Wells
•OTHER:-s.. ' I /g-0 4& ,�� b, 1 , ti � mac- a miaow- t'4.-
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: (1^Ctl,q pr(..n l( Phone Number: 15-9-/Q7) .
Mechanical Company: Lt._be iCre) r J J 6a.S �i' Office Phone9Q7 e3g1, 3S1( Fax 3rY7.6(i.3
Co.Address: t9,01690 6'f 1' c 3-1 • City: 1.Th I/,'1 IA_State: if.- Zip: '1;1,'s-it
License Holder: 71 P Lii,7.4*in !tel (1J/LQ. i-- State Certific ion Registration# 51/,.;
Notarized Signature of License Holder
The foregojeg instrument was acknowledge"tt'efore me this /J"jday of "3u 20/$,in the State of Florida,
County of DO✓qL
Signature of Notary Public
3'o WILLIAM T TATE Personally Known OR[ ] Produced Identification
Notary Public-State oI Florida Type of Identification:
1 a _ .�, Commission/FF 965603
1 \'.n My Comm.Esplm Aug 7,2020 ` Updated 10/9/18
Receipt Number
_ Cash Register Receipt p
City of Atlantic Beach R7343
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $89.00
GSRS18-0114 Address: 318 SEMINOLE RD APN: 170431 0018 $89.00
MECHANICAL $85.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
GAS PIPING OUTLETS 455-0000-322-1000 3 $10.00
TANKS GAS OR LIQUEFIED PETROLEUM 455-0000-322-1000 120 $20.00
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: R7343 $89.00
Date Paid: Wednesday, November 14, 2018
Paid By: WESTERN NATURAL GAS COMPANY
Cashier: CB
Pay Method: CREDIT CARD 1451c
Printed:Wednesday, November 14, 2018 8:58 AM 1 of 1