347 10th GSRS18-0116 MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
GSRS18-0116
PERMIT
ISSUED: 11/20/2018
CITY OF ATLANTIC BEACH EXPIRES: 5/19/2019
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CODE, . CITY OF . . OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
F
ICE: In addition to the requirements of this permit,there may be additional restrictions applicable to this property
may be found in the public records of this county,and there may be additional permits required from other
rnmental entities such aswater management districts,state agencies,orfederal agencies.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
347 10TH ST MECHANICAL RESIDENTIAL GAS Tank & Pipe to Pool Heater $4580.00
TYPE OF SUBDIVISION:ZONING: ING USE
CONSTRUCTION: NUMBER: GROUP: -
170079 0200 ATLANTIC BEACH
ADDRESS:
AEI INTERNATIONAL CORP. 7709 ALTON AVE JACKSONVILLE FL 32211
ADDRESS:
WILSON THOMAS G III 309 9TH ST 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.
7,AN
TION ACCOUNT QUANTITY PAID AMOUNT
OUTLETS 4550000322-1000 1 $10.00
L BASE FEE 455-00 M-322-1000 0 $5500
URCHARGE 455-MM 2080700 0 53.00
RCHARGE 455-0000-208-OGO 0 $2'M
EFIED PETROLEUM7 455-M00-3223000 250 $20.00
TOTAL: 889.00
Issued Date'. 11/20/2018
MECHANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233 b'63
Ph(904)247-5826 Fax (904)247-5845
TOR ADDRESS: 3y� 10� 51 Yee F P�wtuT# G SKSIB-ol�G
PROJECT VALUEAn ARI# REQUIRED
Air Handling Equipment Only _,Air Handling Unit& Condenser ^Condenser Only
%W AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity Tons Per Unit
Heat: UnitQuanmy BTU's Per Unit Seer Rating
Duct Systems: Total CFM REQUIRED
2EPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity Tons Per Unit
Heat: UnitQuantity BTU's Per Unit Seer Rating-
Duct Systems: Total CFM
?IRE PREVENTION
Fire Sprinkler System . Quantity . (Requires 3 sets of plans)
Fire Standpipe Quantity (Requires 3 sets of plans)
Undergrout>d Fire Main %lue fluires
uires 3 sets of plans)
Fire Hose Cabinets Quantity uires 3 sets of plans)
Commercial Hoods Quantity uires 3 sets of plans)
Fire Suppression Systems Quantity 3 sets of phma)
'IRE PLACES MISCELLANEOUS:
Prefabricated Fireplace QtyAutomobile Lifts
(las Piping Outlets Boilers BTU's
Elevato scaiators
,LL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets . 1 Pumps
#Vented Wall Furnaces — Refiageretor Condenser BTU's
#Water Heater Solar Coliection Systems
Tanks(gallons)
Wells
ITHER: 'y r,1/til 266 and -4Q1GV- $ L '4n Vail he t'rer '
milt becomes void If work does not anmmenae within a sir month perled or work is suspended or abandoned for six months.t hereby certify dust 1 have read
s application and know the some to be true and control. All provisions of laws and ordinances governing this wok will be complied with whober specified or
t The permit does not give authority a violate die provisions of my other some or local law.regulation construction or the performance of construction,
operty Owner Name t-Aumy1 QYYIUT Phone Number'4061 -135 X1113
echanical CompanyA I aa.5 S.3rVILPS Office Plumo- -911) Fax III,-336o
).Address: 1109 A�j+�o��n ��AVe City ,1PLVS0yWk State&_Zip J22
cense Holder(Print): SeArc r F Iitl State C fication/Registrtion# 11Mhf
harked Signature of License Holder 3f uta>l:a f"✓
fore me this /yoof No VC4'tt./7c 20 �B
tw.ry vvmic stawawma .,n�s
stoplunus Renee 1010(ase .✓. „:, //p y /�
t�Ze 12s'na gnarure of Notary Public ` N
L0/10 39Vd Stl9I3V 09EETZ1006 SL:60 LT0L/90/E0
ReceiptCash Register Receipt
City of Atlantic Beach R7412
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DESCRIPTION ACCOUNTCITY PAID
PermitTRAK $89.00
GSRS18-0116 Address: 347 10TH ST APN: 170079 0200 $89.00
MECHANICAL $85.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
GAS PIPING OUTLETS 455-0000-322-1000 1 $10,00
TANKS GAS OR LIQUEFIED PETROLEUM I455-0000-322-1000 250 $20.00
STATE SURCHARGES $4'00
STATE DBPR SURCHARGE 655-0000.208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2F.
TOTAL • $89.00
Date Paid:Tuesday, November 20,2018
Paid By:AN INTERNATIONAL CORP.
Cashier:CB
Pay Method:CREDIT CARD 20811
Printed:Tuesday,November 20,2018 9:40 AM 1 of 1