1703 Atlantic Beach GSRS18-0123 MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
GSRS18-0123
PERMIT ISSUED: 12/3/2018
CITY OF AT LANTIC B EACH EXPIRES:6/1/2019
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORM TO THE CURRENT EITH 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 fo nd in the public records of this county,and there may be additional permits required I
governmental entities such aswater management districts,state agencies,or federal agencies. - I
—JOB ADDRESS: PERMITTYPE: DESCRIPTION: VALUE OF WORK:
1703 ATLANTIC BEACH DR MECHANICAL RESIDENTIAL GAS Morip"ing $1135.00
TYPE OF REALESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP: ATLANTIC BEACH
169505138S COU NTRY CLU B U N IT 02
COMPANY: ADDRESS: CITY: STATE: ZIP:
I
CONSTRUCTION 5225 EDGEWOOD CT JACKSONVILLE FL 32254
SOLUTIONS &SUPPLY, U-C
OWNER: ADDRESS: CITY: STATE: ZIP:
TOLL FL VI LIMITED 250 GIBRALTAR RD HORSHAM PA 19044
PARTNERSHIP
I E in add It' In the req
r C ro i t sh u
OT
that may be f.. d n t e P b
governmental enthe such as
Unre"Rent'of this p
Ic record s of this to
water manag.mer
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
must be on City approved list. Container cannot be placed on City right-of"01
FEES
DESCRIPTION A6WUP11 I
SC 'PTIO
G_S S10,00
AS PIPING OUTLETS 455-0000 322 1000 4
"" -UTUET5
M_�C_ CA $55.00
ECHANiCAL 3ASE FIE 455-0000�322-1000 0
N
$2.00
F P'URCH
STATE COPP SURCHARGE 455 MO-208 0700 2
STAT UF'H EG
STATE)CA SURCHARGE
Issued Date: 12/3/2018 101`2
MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
GSRS18-0123
PERMIT ISSUED: 12/3/2018
CITY OF ATLANTIC BEACH EXPIRES: 6/l/2019
�TOTAL $69,00
issued Date:12/3/2018 2 of 2
MECHANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233
Ph(904)247-5826 Fax(904)247-5845
JOB ADDRESS:—170--', Aklle�YJ�f, L-- A, L1. VERmrr#62-S/X-61Z3
PROJECT VALUE ARIO REQUIRED
_.Air Handling Equipment Only _.Air Handling Unit& Condenser _CondenserOnly
NEW 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
REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity Tom Per Unit —
Heat: Unit Quantity BTU's Per Unit— Seer Rating
Duct System: 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—
Elevators/Escalaton
ALL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets 4 Pumps
#Vented Wall Furnaces Refrigerator Condenser BTU's—
#Water Heiders Solar Collection Systems
Tanks(gallons)
Wells
OTHER: C-XQ-,:-, P��!�q br-�P4, -
a I
Per,olt baeornes void if.,k does not confornenes within a six month period or work is suspended or abandoned for six months.I harebyeartify that I have rewi
this application and know the sonve to be tole and connatt. All provisions of laws and ordinervess governing this work will be ernfreplied with whether Specified or
not. The perenit does;not give authority W violate the provisions of my other state of iomi law regulation exrosrains or the perfintranCe deonstruction.
Property O�nersNarne -rol I Qor�LQC-11 -Phone Number
Mechanical CompsanyQcm<xj-�4�)r"(w'sol� vl n 14 S1, Office Phone 399-a-266 a:x3LjiC—U=
Co. Address: city -3&cks0a;jL state PL Zip I-ag
License Holder(Print): Staje Certification/Registrittion# 5�2
1votartzed Signature of License Holder
Before= S' lay 20
Signature of Notary ubl
-A
Cash Register Receipt Receipt Number
City of Atlantic Beach R7506
DESCRIPTION ACCOUNT A=:
PermitTRAK $140.0�0
GSRS18-0123 Address: 1703 ATLANTIC BEACH DR APN: 169505 1385 $69.00
MECHANICAL $65.00
MECHANICAL BASE FEE 1 455-0000 322 1000 1 0 1 $55.00
GAS PIPING OUTLETS 1 455-0000 322-1000 1 4 1 $10.00
STATE SURCHARGES $4.01)
STATE )BPR SURCHARGE ""-208-E7007� $2CO
'80 .. 0
STATE DCA SURCHARGE :�1?2111-2 0600 0 $2L00
GSRS18-0124 Address:1660 ATLANTIC BEACH DR APN:169505 2045 $71.00
MISCHANIM $67.00
MECHANICAL BASE FEE 1000-311- $55.00
109 0
GAS PIPING OUTLETS 4; 1119, $12.00
STATE SURCHARGES $4.00
STATE DEER SURCHARGE 455-0000�208-0700 0 2.00
STATE DCA SURCHARGE 455-0000�208-0600 1�2.00
TOTAL FEES PAID BY RECEIPT: R7506 $140.00
Date Paid: Monday, December 03, 2018
Paid By:CONSTRUCTION SOLUTIONS&SUPPLY, U.0
Cashier: BA
Pay Method: CREDIT CARD 2
Printed:Monday,December 03,2018 10:09 AM 1 Of 1