388 11th GSRS18-0115 MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
m GSRSIB-0115
PERMIT ISSUED: 11/14/2018
; v
CITY OF ATLANTIC BEACH EXPIRES: 5/13/2019
INSPECTIONMUST CALL . t •) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORMTO THE CURRENT 6TH EDITIONt
CODE, AND CITY OF . • OF • .
CONDITIONSALL OF
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.
388 11TH ST MECHANICAL RESIDENTIAL GAS 2 Gas Piping Outlets $700.00
TYPE OF SUBDIVISION:ZONING: ING USE
CONSTRUCTION: NUMBER: — GROUP:
ATLANTIC BEACH
170092 0000
ADDRESS:
CONSTRUCTION 5225 EDGEWOOD CT JACKSONVILLE FL 32254
SOLUTIONS &SUPPLY, LLC
ADDRESS:
COHEN GREGORY M 184 TUSCANY BEND ST DAYTONA BEACH FL 32117
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.
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
GAS PIPING OUTLETS 455-0000332-1000 2 $1000
MECHANICAL BASE FEE 455-0000322-1000 0 $5500
STATE DBPH SURCHARGE
455-0000-208-0700 0
STATEDCA SURCHARGE
455-0000-208-OB00 0 $2.00
TOTAL: $69.00
Issued Date: 11/14/2018 ?
MECHANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233
Ph(904)247-5826 Fax(904)247-5845
JOB ADDRESS: 38�d �11+� «reell"_ PERMT#6SKS/ -6115
PROJECT (VALUE$ 1 7 U O r0 0 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 RatingREQU/RED
Duct Systems: Total CFM
REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION
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 MISCELLANEOUS:
Prefabricated Fireplace Qty Automobile Lifts
Gas Piping Outlets �,_ Boilers BTU's
Elevators/Escalators
ALL OTHER GAS PIPING Heat Exchanger
of Wall Pum s
#QVen ed alll Furnaces _ Refrigerator Condenser BTU's_
#Water Heaters Solar Collection Systems
Tanks(gallons)
Wells
OTHER: r2 crlfri'1• mow` ckgs Aroprz,
Permit becomes void if work does not commence within a sox month period or work is suspended or abandoned for six months.1 hereby testify that I hoe 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
nm. The permit does not give authority to violate the provisions ofany other sate or local law regulation construction or the performance orcorstroafon.
V,r p r L',p�'1e..� Phone Number r10t1 • `I el 1-os'15
Property Owners Name.
Mechanical Company r - �-1— - l�C^1 �'' Q5 0 �in Office Phone 8 - 00 ax�.84-r,
Co.Address City n�fCSrYAty t 119. State-EL Zip 65 q
License Holder(Print): m State Certifimtion/Registration# /a In S 7
Notarized Si nature o .e s o r --r
ygggrs sewn P�aaa suuarwna° ore me this_(lay of `),JNew� eK 20 (�
;1911
Pte ] Devitl Joseph KlolaGo �
9 �r ExOnfmlta9XIL3 �BSaa
Signature of Notary Public-
A ' ReceiptCash Register Receipt Number
rx v City of Atlantic Beach R7351
DESCRIPTION ACCOUNTCITY PAID
OmitTRAK $69•
GSR518-0115 Address: 38811TH ST APN: 1700920000 $69.00
MECHANICAL $65.00
MECHANICAL BASE FEE 455-0322-1000 0 $55.00
GAS PIPING OUTLETS 455-00000-00.322-1000 2 $10.00
STATE SURCHARGES
54 G0
STATE 08PR SURCHARGE 455-0000-208-0700 0 $2.0
STATE DCA SURCHARGE 455-0000.20&0600 0 $2.00
TOTAL • $69.00
CITY OF ATLANTIC BEACH
800 SENINCIIE RD
ATLANTIC BEAC,R 32233
11/14/2018 11:40:09
CREDIT CARD
VISA SALE
Cada 1YKKKK%1DXO(D492
SEQ#: 4
Bawl#: 732
INVOICE 4
Approval Code: 002861
Enlry WWI: Manual
Mode', Onlhe
Tax Mauri: $0.00
Cad Code: M
SALE AMOUNT $69,00
CUSTOMER COPY
Date Paid:Wednesday, November 14,2018
Paid By:CONSTRUCTION SOLUTIONS&SUPPLY, LLC
Cashier: BA
Pay Method: CREDIT CARD 4
Printed:Wednesday,November 14,201811:40 AM 1of1