1727 Atlantic Beach Dr GSRS18-0136 gas permit MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
PERMIT GSRS18-0136
ISSUED: 1/2/2019
CITY OF ATLANTIC BEACH EXPIRES: 7/1/2019
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 .
L 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:
1727 ATLANTIC BEACH DR MECHANICAL RESIDENTIAL GAS GAS PIPING -4 FIXTURES $1135.00
TYPE OF REALESTATE BUILDING USE
ZONING: SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
1695051440 ATLANTIC BEACH
COUNTRY CLUB UNIT 02
COMPANY: ADDRESS: CITY: STATE: ZIP:
CONSTRUCTION 5225 EDGEWOOD CT JACKSONVILLE FL 32254
SOLUTIONS &SUPPLY, LLC
OWNER: ADDRESS: CITY: STATE: ZIP:
ATLANTIC BEACH 414 OLD HARTS RD STE 502 FLEMING ISLAND FL 32003
PARTNERS LLC
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 AlliiiiII&
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
GAS PIPING OUTLETS 455-0000-322-1000 4 $10.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
STATE DBPR SURCHARGE 455-0000-208-0700 1 0 1 $2'00
STATE DCA SURCHARGE 455-0000-208-0600 C) $2.00
Issued Date: 1/2/2019 1 of 2
MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
PERMIT GSRS18-0136
ISSUED: 1/2/2019
CITY OF ATLANTIC BEACH EXPIRES: 7/l/2019
TOTAL:$69.00
Issued Date: 1/2/2019 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: f)�('C_ 1� (-. PERMrr#
PROJECT VALUE $ 16 ,t,(;� — ARI# 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 BTU's Per Unit Seer Ratin
Duct Systems: Total CFM 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
Elevators/Escalators
ALL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets 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
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
.iot. The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name TC)li, V-'4�Z,(-S Phone Number
C
Vechanical Company Qof)4T\,\C-��ICW� ��A uAlc-)Y-)C)'� Office Phone ax ?)?c'f-b7 2-2-
-o. Address: 'C') CityA, State il zip
License Holder(Print): ,State Certification/Registration# ID
vot i er
_410h I tary Public state of Florida
David Joseph Klotz ore me this -51 dayof 1)e(-e1-nb,-,- 20 IS'
My Commission GG 239595
Expires 07/18/2022
ig
Xmin nature of Notary Public
Cash Register Receipt Receipt Number
City of Atlantic Beach R7739
DESCRIPTION ACCOUNT QTY PAID
PerrnitTRAK $69.00
GSRS18-0136 Address: 1727 ATLANTIC BEACH DR APN: 169505 1440 $69.00
MECHANICAL $65.00
MECHANICAL BASE FEE 455-0000-322-1000 1 2-= $55.00
GAS PIPING OUTLETS 455-0000-322-1000 1 4 1 $10.00
STATE SURCHARGES $4.00
STATE DBPR SURCHARGE 455-0000-208-0700 1 0 1 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 1 0 $2.00
TOTAL FEES PAID BY RECEIPT: R7739 $69.00
CITYZF ATIANTIC BEACH
800 SEIVINCLE RD
ATLANTIC BEAC,FL 32233
01�02,2019 11:26:39
CREDIT CARD
VIS�,SALE
Card XXXXXXXXXXXX0492
SEQ 5
Bati:h#: 762
INVOICE 6
Approval Code: 091810
Entry Method: Manual
Mode: Online
Tax Amount: $0.00
Card Code: M
SA[E AMOUNT $69.00
CUSTOMER COPY
Date Paid: Wednesday, January 02, 2019
Paid By: CONSTRUCTION SOLUTIONS &SUPPLY, LLC
Cashier: BA
Pay Method: CREDIT CARD 5
Printed:Wednesday,January 02,2019 11:27 AM Z-
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