562 Timber Bridge GSRS18-0120 MECHANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Reach, Fl,32233 gesig- 009,1
Ph(904)247-5826 Fire(904)247-5845
JOB ADDRESS: Lc,,:,:E�- - PERMrr# 6,SRS1?-61Z0
PROJECT VALUE$ '0 ARI# QUIRED
_.Air Handling Equipment Only _.Air Handling Unit& Condenser _CondenserOnly
NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity Tom 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 Tons Per Unit
Heat: Unit Quantity BTU's Per Unit Seer Ratin 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 Bogle 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
BTU's
Gas Piping Outlets Boilers
Elevators/Escalators
ALL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets Pumps
#Vented Wall Furnaces Refrigerator Condenser BTU's
#Water He aters Solar Collection Systems
1+
OTH
k dm not orronerce within a six nnorath period or work is suspended or abandoned for six anonths,I hereby esdity mat I new reso
thi..ppliestion and knew the surne to be me and correct All provisions of laws and ordiessucm governing this work will be earropliedi with whether specified or
not. The permit does net give authority to violate the provisions of my other suar or local law regulation Construction or the Pdonauserce,of ronstraction.
Property Owners N Phone Number
ffice Phone 32a:22WFax c
Mechanical Company C�r)4rjNj'C6'�1,�1A)Ml.G1 A-�O —j? iiL22:Z
Co. Address:.1�2�IVE t�Nkcq �220, 1 :1 City� y 4- StateLL—Zip 3LA�6
71 ..cationtrue
'e'-ert
License Holder(Pr PIC!, S te Certification/Registration
Notarked Signature f Iticense Holde, A
,fto teOt e 20
1`?-M day of P
Notar,PubleStawdRadde Be a this—_d.v of
My ConvasOcn Go 239595 Signature of Notary Public
E."a"11812122
YER I
MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
GSRS18-0120
PERMIT ISSUED: 11/26/2018
CITY OF ATLANTIC BEACH EXPIRES: 5/25/2019
ALL WORK MUST CONFORM TOTAL (ALINNIt,I I 'In I
CODE, NEC, IPIVIC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
ional restrictions applicable to this property
u.n.
N FOTICE:71naddition to the requirements of this permit,there may be addit ed from other
It
tha may be found in the public records of this county,and there may be additional permits requi
`uo
governmental entities such as water management districts,state agencies,or federal agencies.
5 BER BRIDGE LN MECHANICAL RESIDENTIAL GAS Gas Piping for 5 Outlets $1275.00
TYPE OF REALESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
ATLANTIC BEACH
169505 2140 COUNTRY CLUB UNIT 02
CONSTRUCTION S225 EDGEWOOD CT JACKSONVILLE FL 32254
SOLUTIONS &SUPPLY, LI-C
OWNER: ADDRESS: CITY: STATE: — ZIP:
TOLLFLVI LIMITED 250 GIBRALTAR RD HORSHAM PA 19044
PARTNERSHIP
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
BY.
Roll off container company must be on City approved list. Container cannot be placed on City right-c,f-w
777 DESCRIPTION ACCOUNT
GAS PIPING OUTLETS 455 COCO 322-10�
MECHANICAL BASE FEE 455-ODW 322 1000
STATE DBPR SURCHARGE 455 0000 208 0700
STATE DCA SURCHARGE
411——8060"
issued Date: 11/26/2019 1 of 2
MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
PERMIT GSRS18-0120
ISSUED: 11/26/2018
Imp CITY OF ATLANTIC BEACH EXPIRES: 5/25/2019
TOTAL:$71.00
issued Date: 11/26/2018 2 of 2
Cash Register Receipt Receipt Numbe
to City of Atlantic Beach R7449
DESCRIPTION 0
PerrnitTRAK $71.00
GSR518-0120 Address: 562 TIMBER BRIDGE LN APN: 169505 2140 $71.00
$67.00
MECHANICAL
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
5
GAS PIPING OUTLETS 455 0000-322-1000 $12.00
$4.00
STATE SURCHARGES 00
STATE DBPR SURCHARGE 455-0000-208 0700 1 $2�.00
w 455-0000-209-0600 5",
STATE QQ SURCHARGE 1 0 52.00
TOTAL FEES PAID BY RECEIPT: R7449 $71.00
Date Paid: Monday, November 26, 2018
Paid By: CONSTRUCTION SOLUTIONS&SUPPLY, U-C
Cashier: CB
Pay Method: CREDIT CARD 51018
Printed:Monday,NoverrIber 26,2018 4:40 I'M 10IF1