1746 MARITIME OAK DR GSRS19-0003 GAS PERMIT MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
PERMIT GSRS19-0003
ISSUED: 1/14/2019
CITY OF ATLANTIC BEACH EXPIRES: 7/13/2019
MUST CALL INSPECTION • • • 14) 247-5814 BY 4 PM FOR NEXT DAY • •
ALL WORK MUST CONFORMTO THE CURRENT 6TH EDITION1 OF • '
CODE, • OF • OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, . .
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:
1746 MARITIME OAK DR MECHANICAL RESIDENTIAL GAS install 4 gas-piping outlets $1135.00
TYPE OF
• • GROUP:
169505 1850 ATLANTIC BEACH
COUNTRY CLUB UNIT 02
COMPANY: ADDRESS:
CONSTRUCTION 5225 EDGEWOOD CT JACKSONVILLE FL 32254
SOLUTIONS &SUPPLY, LLC
• .D• '
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 . .
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
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 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
Issued Date: 1/14/2019 1 of 2
MECHANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
[[ 11 Ph(904)247-5826 Fax (904) 247-5845 ASV_51 Cj
JOB ADDRESS: _ I � �1 c M ctir-`�nU CCK Or-- PERMIT#
PROJECT VALUE $-) � J , o 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 Rating
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 —T— Solar Collection Systems
Tanks (gallons)
Wells
Lv Y,c,,: I
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 read
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
not. The permit does not give authority to violate theprovisionsof any other state or local law regulation construction or the performance of construction.
Property Owners Name J-0 Phone Number
- . iz11 � 0
O1{Mechanical Company � � > � OfcePhone _sZ-l (xFax�8°
-b1�1-m
Co. Address: k e U> C,4� CA- City Stater"L Zip 3�2 5 L
License Holder(Print): o rir tate Certification/Registration# aeo(0
Notarized Signature of License Holder ! f
,o ,t Notary Public State of Florida Be ore me this 0'� day of J 0.v%v a�7 20 l �
in David Joseph Klotz
My Commission GG 239595 Ignature of Notary Public- -
�p Ao Expires 07/18/2022 Y
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01__ A— r, r,rv,
Receipt •
A Cash Register Receit
•
City
of Beach R7825
DESCRIPTION • QTY PAID
PermitTRAK $69.00
GSRS19-0003 Address: 1746 MARITIME OAK DR APN: 169505 1850 $69.00
MECHANICAL $65.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
GAS PIPING OUTLETS 455-0000-322-1000 4 $10.00
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 $69.00
CITY OF ATLANTIC BEACH
800 SENINCLE RD
ATLANTIC B=AC,FL 32233
01;14,2019 06:41:42
CREDIT CARD
VISI,SALE
Card XXXXXXXWXX0492
SEQ;: I
Batch 770
INVOICE I
Approval Code: 042737
Entry Method: Manual
Mode: Onlhe
Tax Amount: $0.00
Card Code: M
SALE AMOUNT %91
CUSTOMER COPY
Date Paid: Monday,January 14, 2019
Paid By: CONSTRUCTION SOLUTIONS &SUPPLY, LLC
Cashier: BA
Pay Method: CREDIT CARD 1
Printed: Monday,January 14,2019 8:43 AM 1 of 1
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