278 SEMINOLE RD - HVAC I
5I,ib`J.)>tx MECHANICAL RESIDENTIAL HVAC PERMIT NUMBER
ACRS18-0488
�4 - : PERMIT •
V }) ISSUED: 11/30/2018
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CITY OF ATLANTIBEA
. EXPIRES: 5/29/2019
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:
278 SEMINOLE RD MECHANICAL RESIDENTIAL 3 Ton 36K BTU 1200 CFM $3200.00
HVAC HVAC Unit
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
170512 0000 SALTAIR SEC 01
COMPANY: i ADDRESS: CITY: STATE: ZIP:
AIR TO AIR 11578 DAVIS CREEK CT JACKSONVILLE FL 32256
OWNER: ADDRESS: I CITY: STATE: ZIP:
LAGNER JENNIFER A 278 SEMINOLE RD ATLANTIC BEACH FL 32233-4143
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
AC AND REFRIGERATION 455-0000-322-1000 3 $24.00
AIR DUCT SYSTEM 455-0000-322-1000 1200 $20.00
FURNACES AND HEATING 455-0000-322-1000 36000 $24.00
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
Issued Date: 11/30/2018 1 of 2
rs''�''fl, MECHANICAL RESIDENTIAL HVAC PERMIT NUMBER
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Jz r -'\=4; ACRS18-0488
' PERMIT
ISSUED: 11/30/2018
-A-% ;;„! ~ CITY OF ATLANTIC BEACH EXPIRES: 5/29/2019
TOTAL:$127.00
Issued Date: 11/30/2018 2 of 2
MECHANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233 o cak
Ph (904)247-5826 Fax(904)247-5845 I i c
JOB ADDRESS:C.1 Se <L..V l n C i Le Rol. , PERMIT# ZrS t --C
PROJECT VALUE$ ,-- 7C )C-
ARI# (t I CQ L1—t ? CI 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 1 BTU's Per Unit VI Seer Rating \\---\
Duct Systems: Total CFM \Z-C:>C REQUIRED
REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity Tons Per Unit
Heat: Unit Quantity BTU's Per Unit Seer Rating
Duct Systems: Total CFM • REQUIRED
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
ALL OTHER GAS PIPING levators/Encalators
H
Quantity of Outlets Heat Exchanger
Pumps
#Vented Wall Furnaces
Refrigerator Condenser BTU's
#Water Heaters Solar Collection Systems
Tanks(gallons)
Wells
OTHER:
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 vio ate the provi. 'sions of y other state or local law regulation construction or the performance of construction.
Property Owners Name�� k ``� Phone - Ui`O
Number���,
Mechanical Com an \� -' 2'�l"L�al qG-t Zt0'Z- -1"Z
p y \-\C�� Office Phone Fax
�' Da .j. €..•
Co. Address: -' - City ,\CLC�va.��State v-\Zip137261p
License Holder(Print): S 1'tI r 1
State Certifica 'on/Registration# CAC 1$152,4(0
Notarized Signature of License Holde 6.; ill
~."-"'�yr; TERESAL MUE• LLER Bd.. me this .30"� day of I�O' - 20
r. MY COMMISSION#GG 194502 Signature of •tary Public J R�'
r' U EXPIRES:March 17,2022
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.�Ar iyo�. Bonded T nj Notary Pubic Under*Ttte(6
Cash Register Receipt Receipt Number
r City of Atlantic Beach R7500
DESCRIPTION I ACCOUNT QTY I PAID
PermitTRAK $127.00
ACRS18-0488 Address: 278 SEMINOLE RD APN: 170512 0000 $127.00
MECHANICAL $123.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
AC AND REFRIGERATION 455-0000-322-1000 3 $24.00
AIR DUCT SYSTEM 455-0000-322-1000 1200 $20.00
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: R7500 $127.00
CITY OF ATLANTIC BEACH
800 SENINOLE RD
ATLANTIC BEAC,FL 32233
11/30,2018 14:55:56
CREDIT CARD
VISI,SALE
Card a XXXXXXXXXXXX0064
SEQ#: 5
Batch u: 742
INVOICE 5
Approval Code: 01842G
Entry Method: Manual
Mode: Online
Tax Amount: $0,00
Card Code: M
SALE AMOUNT X127,00
CUSTOMER COPY
Date Paid: Friday, November 30, 200
Paid By: AIR TO AIR
Cashier: BA
Pay Method: CREDIT CARD 5
Printed: Friday, November 30,2018 2:57 PM 1 of 1
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