1678 ATLANTIC BEACH DR GSRS19-0008 GAS PERMIT MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
-0008
PERMIT GSRS19
CITY OF ATLANTIC BEACH ISSUED: 1/18/2019
EXPIRES: 7/17/2019
U, 19
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.
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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:
1678 ATLANTIC BEACH DR MECHANICAL RESIDENTIAL GAS install gas-piping outlet $500.00
TYPE OF REALESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
1695051720 ATLANTIC BEACH
COUNTRY CLUB UNIT 02
COMPANY: ADDRESS: CITY: STATE: ZIP:
AA BOTTLED GAS 12601 N MAIN ST JACKSONVILLE FL 32218
COMPANY INC
OWNER: ADDRESS: CITY: STATE: ZIP:
TOLL FL VI LIMITED 250 GIBRALTAR RD HORSHAM PA 19044
PARTNERSHIP
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 $SS.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
Issued Date: 1/18/2019 1 of 2
MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
GSRS19-0008
PERMIT
ISSUED: 1/18/2019
CITY OF ATLANTIC BEACH
EXPIRES: 7/17/2019
TOTAL:$69.00
Issued Date: 1/18/2019 2 of 2
Mechanical Permit Application "ALL INFORMATION
HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: bo C
JOB ADDRESS: 1678 Atlantic Beach Drive PROJECT VALUE$500-00
NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI#(REQUIRED)
13 Air Hondling Equipment Only 0 Condenser Only 0 Air Handling Unit& Condenser
Air Conditioning: Unit Quantity Tons per Unit
Heat-. Unit Quantity BTUs per Unit Seer Rating (REQUIRED)
Duct Systems: Total CFM
[]REPLACEMENT AIR CONDITIONING& HEATING.SYSTEM INSTALLATION ARI#(REQUIRED)
[I Air Hondling Equipment Only 0 Condenser Only El Air Hcndling Unit& Condenser
Air Conditioning: Unit Quantity Tons per Unit
Heat: Unit Quantity BTU's Per Unit Seer Rating(REQUIRED)
Duct SysteM5: Total CFM
7FIRE 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)
F_�FIRE PLACES r7 MISCELLANEOUS,
Prefabricated Fireplace(Qty)_ Automobile Lifts
Gas Piping Outlets Boilers BTUs
Elevators/Escalators
ALL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets Pumps
#Vented Wall Furnaces Refrigerator Condenser BTUs
Water Heaters Solar Collection Systems
Tanks (gallons)
Wells
F,/�OTHER: Run loft of gas line from Natural Gas meter to heater.
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 correc-,. All provisions of laws and ordinances governing Ws
work will be complied with whether specified or not. The permit does not give auplorlty to violate the provisions of any other state or
local law regulation construction or the performance of construction. T�,
_L 9D4-
owner Name-. Eddie-G.Thigpen- 1(, 11 j� one Number: 757-1924
Mechanical Company: AA Bottled Gas Co Office Phone: 904-757-1924 -Fax
Co, Address: 1,2601 North main street City: Jackson-ville state: FL Zip: 32218
License Holder:-Eddie G.Thigpen State Certification/,Registration# 01320
Notarized Signature of License Holder
The foregoing instrumen� cknowledged before me this o f of Florida,
L was a 20_j in the State
County of
Signature of Notary Publi
9 J iNY E.BROOKS H-Personally Known OR duced Identiiffication
OHI Type of ldcntification;
MYWMMI0N#G(i123967
Sptmbgr 11,2021 Vodoted 1019118
EXPIRES,
EE9
Cash Register Receipt Receipt Number
IN City of Atlantic Beach R7896
DESCRIPTION ACCOUNT CITY PAID
PermitTRAK $69.00
GSRS19-0008 Address: 1678 ATLANTIC BEACH DR APN: 169505 1720 $69.00
MECHANICAL $65.00
MECHANICAL BASE FEE 455-0000-322-1002__�_0 $55.00
GAS PIPING OUTLETS 455-0000-322-1000 1 $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 FEES PAID BY RECEIPT: R7896 $69.00
Date Paid: Friday, January 18, 2019
Paid By: AA BOTTLED GAS COMPANY INC
Cashier: CB
Pay Method: CREDIT CARD 10689
Printed:Friday,January 18, 2019 4:41 PM 1 of 1