663 SELVA LAKES CIR - GAS rs\-- !T MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
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PERMIT GSRS18-0128
^ `- ISSUED: 12/12/2018
`�,� V CITY OF ATLANTIC BEACH EXPIRES: 6/10/2019
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:
663 SELVA LAKES CIR MECHANICAL RESIDENTIAL GAS set 2 100 gal. tanks & install $623.95
interior gas line to range
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
172027 5892 SELVA LAKES UNIT 03
COMPANY: ADDRESS: I CITY: STATE: ZIP:
AEI INTERNATIONAL CORP. 7709 ALTON AVE JACKSONVILLE FL 32211
OWNER: I ADDRESS: CITY: STATE: I ZIP:
BYERS NANCY B 13753 NIGHT HAWK CT JACKSONVILLE FL 32224
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
GAS PIPING OUTLETS 455-0000-322-1000 1 $10.00
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
TANKS GAS OR LIQUEFIED PETROLEUM 455-0000-322-1000 200 $20.00
TOTAL: $89.00
Issued Date: 12/12/2018 1 of 2
1,V1- ILU AINICAL rE.10111. AITLICATION
CITY OF ATLANTIC BEACH
• 800 Seminole Rd Atlantic Beach, FL 32233
Ph (904) 247/l-�,5�_826 Fax(904) 247-5845 6 s r-- $s _ o is '
LOB ADDRESS: Ce 60 �J Se.'Vet La kis (1, , PERMIT#
PROJECT VALUE $ C' Z', . 9 5 ARI# REQUIRED ,
Air Handling Equipment Only _=Air Handling Unit & Condenser Condenser Only
sEW 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
tEPLACEMENT 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 Qualitity (Requires 3 sets of plans)
'IRE PLACES MISCELLANEOUS:
Prefabricated Fireplace Qty__ Automobile Lifts
Gas Piping Outlets Boilers BTU's
Elevators/Escalators
LLL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets Pumps
#Vented Wall Furnaces Refrigerator Condenser BTU's
# Water Heaters Solar Collection.Systems •
Tanks (gallons) ,..2-/D00 e. .
Wells J
)THERike r s `
: _ bo /.l rne. 7iD rah•e -i <- -- 00
emit becomes void if work does not commence within 2 six month period or work is suspended or abandoned for six months,I hereby certify that I have read
s application and know the same to be true and correct. All provisions of laws and ordinances governing this work will be domplied with whether specified or
t. The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of construction.
operty Owners Name Mint S Phone Number 33 3^ 5 6'3
echanical Company .r'yr P Y vas � c,e,5 Office Phone #7,29 77I Fax
J. Address: 770 9 /Rim /Ike- City JQ(,tfd vllle, State .Zip 31 1/
ieense Holder (Print): l e Jj Mead •_,, v'ed Ii n State Certificationikegistration# 16111
otarized Signature o License Ifo der . . . .
Notary Public sate a/915'r". i efore me this 1 -- day of f46rvt x e. • 20 j8
li • ttenle Renee Mol;uuiree - •
t
MyCcmosioi;n GG1232Se ` '&,,..,:a_alb•a8�ov2D2ti 'A gnature of Notary Public` i �. I )
•
I0/I0 39Vd Sd9I3V O EEIZLOO6 ZI :L0 ZIOZ/VZ/E0
1 .
J Cash Register Receipt Receipt Number
' p`^ zCity of Atlantic Beach R7601
-'13.1 ormm9%'
DESCRIPTION I ACCOUNT I QTY I PAID
PermitTRAK $89.00
GSRS18-0128 Address: 663 SELVA LAKES CIR APN: 172027 5892 $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 455-0000-322-1000 200 $20.00
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: R7601 $89.00
Date Paid: Wednesday, December 12, 2018
Paid By: AEI INTERNATIONAL CORP.
Cashier: CB
Pay Method: CREDIT CARD 12566
Printed:Wednesday, December 12, 2018 11:34 AM 1 of 1 ti