1671 W Park Terr GSRS18-0132 mech gas permit MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
GSRS18-0132
PERMIT ISSUED: 12/19/2018
CITY OF ATLANTIC BEACH
EXPIRES: 6/17/2019
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.
40TICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property
hat may be found in the public records of this county, and there may be additional permits required from other
rovernmental entities such as water management districts, state agencies, or federal agencies.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
1671 W PARK TER MECHANICAL RESIDENTIAL GAS install 3 gas-piping outlets & $1200.00
water heater
TYPE OF REALESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
1720200332 SELVA MARINA UNIT 07
COMPANY: ADDRESS: CITY: STATE: ZIP:
GAS APPLIANCE 4007 SAN BERNADO DR JACKSONVILLE I'L 32217
SPECIALISTS
OWNER: ADDRESS: CITY: STATE: ZIP:
JOSEPH & KATHERINE 1671 PARK TER W ATLANTIC BEACH FL 32233-5609
ALBERTI
VARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT
N YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
:OMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST
NSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
kTTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
LIST OF CONDITIONS
toll 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 3 $10.00
MECHANICAL BASE FEE 45S-0000-322-1000 0 $55.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
45S-0000-208-0600 200
STATE DCA SURCHARGE 0 s7
Issued Date: 12/19/2018 1 of 2
MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
GSRS18-0132
PERMIT
ISSUED: 12/19/2018
CITY OF ATLANTIC BEACH EXPIRES: 6/17/2019
VENTED WALL FURNACE WATER HEATER UNIT 455-0000-322-1000 1 $5.00
TOTAL: $74.00
Issued Date: 12/19/2018 2 of 2
Lit:"v 10 1 u VU.40d k7w5/Appliarlue opeulallsLt; �;IU44'1 V�000 P.1
From: Harry Mayes ha,,,eloLjmb�ng(:c?comeazt.ni)i df
subiect: Atlantic Beach
D:Rte: I)eember-17,29118 at 4*.06 PM
To: Dan Smith —It, Danid Smith gasmar-dar,@,co-ne-ast.nel
04AU IWCRMATXM
Mechanical Permit AppliCatiOn 1*4wtnwwlm
Cky of Atlantic Beach Building Departroent G"If IS'"AuNtm
:7 800 Seminoie Rd,A-11antic Beach,FL 32233
Phone, (904)247-5926 Emailz Pf RMT It!
IOSADDRESS- 16-11 PRojEcrVALUE.$
Fj NEW AIR CONDITIONENG&HEATING SYSTEM INSTALLATION AR19MAEOWRED)
0 Air HandYing Equiprrwrlt 0r1-1Y 0 Cordens&On!'v 0 Air HandYing Upir Z Cordeftwr
P&Covdirioning-. Unit Quantity Tons per Unit
4eat: Unit QLc,3rttjrV BTU&per Llgit_- Seer Rating(REQURED)
Duct Systems: Tt�tal CFM
F(REPILACEMENT AM CONDITIONING&HEATING SYSTEM tMTALLATtON ARJ#WQU1RED)
0 Air Handfrig Equipment OftrY 0 Condenser Oniy C2 Air�4andling Unit&C004*Awt
AirCordtioning: UnitQLrantitv- TOrtsPe(Unit Seer Rating(RE00RED)
Heat: JniL Quantity BTLfs Per Unit
Duct Sy Ste rhs: Total CFNt
OrtiRE PREVENTION (Requi res 3 w ts of pla ns)
Fire Sprinkler%-stem (luantiLy
Fire Standpipt, OuantlLy (Requires 3 sets Of Marks)
Underground Fire Main 'value (Requires 3 wt-s of plans,)
Fire Rose Cabirleu Quantity (Requires 3 SeU of Plans)
Commercial Hoods Quantity (K equi res I sets of platu)
Fire StippreSSiOi'Systems Quantity (Requirps 3 sets of p�ans)
F--JPtRE PLACES 0MISCELLANEOUS:
r-trefabricatec Fireplace [Qty)- Autctmbile Lifts
V ro Piping Outlets Boilers 13TUs
Elevators/llcalators
'ALL OTHER GAS PIPING Keat Exchanger
Quantity of ou'le-ts Pumps
#Vented Wall Furnaces Refrigerator Conderiser BTUS
#Water Heaters Solar CollecLion System
Tanks(gallons)
e- Wells
f-10'THEW.,
t,,�rm.t 1,tLz�m es�"�I if W�1*'d--*s r�;'t w a 5 A r1tonth ne r LA of wo'*,s S usi>md eo or a barwnt for 5,K f*Ortl'4�
%v-jri at not. the 0-ef-wt-znm�rol ovwtsonsof wyothef statp w
C"ner Name: P h o ne N u m b Par:
-00c*. e- 6c,Q.Th Office Phu
Wechalzai carroznv nJWL43-6-922-0
Co.Add ress: 401b') -Sln City:
License Holderr I, State Cerliti cad onj Registra tjcn# 57 S-
:EJ
ftturbod SignaWte of.Ucen me Hdder
Theforegrint,in�trurnentivvasazknowIedged beforeme this 1_0_-dzyofD 4,-j: in the St3b?of F�--rida-
AJOL _
County of. Signatur4--of 4.-it3ry Pub5c v
lV5'Per-.onaIIyKna%vn0Rj 1 Produced Identification
Type of Identification:
1,c Nota0rkvP`ubac StatLz4two,f4lwF:Imroiwri,di*an
L 14
sey �V GG 11IM73
indsey N.Moody
C
b./ My Commission GG 110673
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Expires 06/01/2021
Receipt Number
Cash Register Receipt
City of Atlantic Beach R7675
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $74.00
GSRS18-0132 Address: 1671 W PARK TER APN: 172020 0332 $74.00
MECHANICAL $70.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
GAS PIPING OUTLETS 455-0000-322-1000 3 $10.00
VENTED WALL FURNACE WATER HEATER 455-0000-322-1000 1 $5.00
UNIT
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: R7675 $74.00
Date Paid: Wednesday, December 19, 2018
Paid By: GAS APPLIANCE SPECIALISTS
Cashier: CB
Pay Method: CREDIT CARD 5
Printed:Wednesday, December 19, 2018 2:04 PIVI 1 of 1