1202 Jasmine ACRS18-0492 MECHANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233 y" �
Ph(904)247-5826 Fax(904)247-5845 0 S��—b ( �Z
JOB ADDRESS: X02 1 Qc�,'Anl o ��' PEBm rr# Z1
PROJECT VALUE$ x, 100 / ARI# -iC\q 511 , REQUIRED
_Air Handling Equipment Only \/AIC Handling Unit& Condenser _Condenser Only
NEW AIR CONDITIONING&HEATING SYSTEM INSTALLATION
Au Conditioning: Unit Quantity,_ Tons Per Unit Z 5-
Heat: Unit Quantity BTU's Per Unit Seer Ratin L
Duct Systems: Total CFM REQUIRED
REPLACEMENT AIR CONDITIONING& HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity Tons Per Unit
Duct Systems: TotalUnit CFM ntity BTU's Per Unit Seer Rating
REQUIRED
FIRE PREVENTION
Fire Sprinkler System Quantity (Requires 3 sets of plans)(Requires 3 sate of plans)
Fire Standpipe Quantity
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 seta of plans)
FIRE PLACES MISCELLANEOUS:
Prefabricated Fireplace Qty Automobile Lifts
Gas Piping Outlets Boilers BTU's
ALL OTHER GAS PIPING Elevators/Escalators
Quantity of Outlets Heat Exchanger
#Vented Wall FurnacesPumps
#Water Heaters Refrigerator Condenser BT _
Solar CollectU's
ion Systems
Wanks(gallons)
ells
OTHER:
rmtMt become void ifworkdms not eommmoe within a sixteenth padod mwmk is suspended orabandwwd for six I ths.lherebyomtifythatihammd
this application and know the ntee to be tmand wrect All p ugdons of laws and ordinanom aoveeing this wnk will be eompliedwith.whMmapeciaW m
not The permit doe not ithm'"thmity to violate theptevislom ofany mhmateto lucallaw reauled conebvcaon or thoperfmr�nonce ofcomWctiam.
Property Owners Name A\�(�.\al (��Cl`\�U�\-�n� gPhho�n.Nnmbd'����Z o �✓ 1
Mechanical Company, ++C��-\`C�' ' Office Pfione -421 F�caA-'Ha�'1
Co.Address: City .,ClC rf.(\\n estate-R!\Zip?�p
License Holder(Print): 3 tate Cerdfica on/Registration#CQ 18f_ z {1=(.
Noaarized Signature ofacense Hold,
t ..., rmEset MUEnea ' Be me this 5" dayof�( eC<„- 6c-r 20 iii
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r• MrcoMMtssiosscc+sawz Signature of
Public ]1 ^
1 E%PIK&Marhlr2M tart' ✓4i '
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MECHANICAL RESIDENTIAL HVAC PERMIT NUMBER
PERMIT ACRS18-0492
ISSUED: 12/6/2018
V CITY OF ATLANTIC BEACH EXPIRES: 6/4/2019
PHONEMUST CALL INSPECTION r • FOR DAY INSPECTION.
ALL WIRK MUST CfNFIRM • • . r 1F TWE FLOFIDA-BUR—MV43
CODE, . CITY OF • • 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:
1202 JASMINE ST MECHANICAL RESIDENTIAL $3100.00
HVAC
TYPE OF REALESTATE ZONING: BUILDING USE SUBDIVISION:
• • GROUP:
1710200030 ATLANTIC BEACH SEC H
COMPANY: ADDRESS:
AIRTOAIR 11578 DAVIS CREEK CT JACKSONVILLE FL 32256
• ADDRESS:
PILLAR LLC 3167 ST JOHNS BLUFF RD S JACKSONVILLE FL 32246
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.
"DE.SC.RlPTIOIN ACCOUNT QUANTITY PAID AMOUNT
TION 455-0000322-1000 2.5 $1600
AIR DUCT SYSTEM 455-0000322-1000 1000 $2000
FURNACES AND HEATING 455-0000-322-1000 30000 $24.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
STATE DEER SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-00002080600 0 $2.00
Issued Date: 12/6/2018 1 of 2
,s MECHANICAL RESIDENTIAL HVAC PERMIT NUMBER
m ACRS18-0492
PERMIT
ISSUED: 12/6/2018
CITY OF ATLANTIC BEACH EXPIRES:6/4/2019
--- TOTAL:$119.00
Issued Date: 12/6/2018 2 of 2
Cash Register Receipt 1
go
1
DESCRIPTION
PermitTRAK $119.00
ACRS18-0492 Address: 1202 JASMINE ST APN: 1730200030 $119.00
MECHANICAL $115.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55,00
AC AND REFRIGERATION 455-0000-322-1000 3 $16.00
AIR DUCT SYSTEM 455-0000.322-1000 1000 $20.00
FURNACES AND HEATI NG 455-0000-322-1000 30000 $24.00
STATESURCHARGES $4'00
STATE DEER SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000.208-0600
TOTALE 1 $119.00
Date Paid:Thursday, December 06, 2018
Paid By:AIR TO AIR
Cashier:CB
Pay Method:CREDIT CARD 3808g
Printed:Thursday,December 06,20383:33 PM S0f1