76 ARDELLA RD MECH RES HVAC PERM MECHANICAL RESIDENTIAL HVAC PERMIT NUMBER
s PERMIT ACRS19-0021
ISSUED: 2/11/2019
CITY OF ATLANTIC BEACH EXPIRES: 8/10/2019
MUST CALL • • • • • 1 PM FOR • •
ALL WORK MUST CONFORMTO THE CURRENT 6TH EDITION1 OF • '
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:
MECHANICAL RESIDENTIAL
76 ARDELLA RD HVAC replace 2-ton 24K-BTU AHU $4898.00
TYPE OF • BUILDING
ZONING: :D •
• • GROUP:
172048 0000 SECTION LAND
COMPANY: ADDRESS:
AIR SOURCE AMERICA INC 207 20th st N JACKSONVILLE FL 32250
BEACH
• ADDRESS:
KACHERGUS MATTHEW ET
AL 76 ARDELLA RD ATLANTIC BEACH FL 32233
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.
I
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
AC AND REFRIGERATION 455-0000-322-1000 2 $16.00
FURNACES AND HEATING 455-0000-322-1000 24000 $24.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
Issued Date: 2/11/2019 1 of 2
MECHANICAL RESIDENTIAL HVAC PERMIT NUMBER
r > PERMIT ACRS19-0021
ISSUED: 2/11/2019
CITY OF ATLANTIC BEACH EXPIRES: 8/10/2019
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $99.00
Issued Date:2/11/2019 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
AC�S� `� -ova l
JOB ADDRESS: 76 Ardella Rd, Atlantic Beach, FL 32233 PERMIT 4
PROJECT VALUE S 4898.00 ARI# 9674745 REQUIRED
Air Handling Equipment Only x ,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 1 Tons Per Unit 2
Heat: Unit Quantity 1 BTU's Per Unit 24,000 Seer Rating 14
Duct Systems: Total CFM 0 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%oid if Nark dues not commence within a six month period or work is suspended or abandoned lisr six months. I hereby certih that I have road
this application and know the some to he true and correct. All provisions of laws and ordinances governing this work will he complied with whether specified or
not. The permit does not give authority to N iulate the provisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name &0 01,yJ KO[Chwit-s Phone Number 904250-7720
Mechanical Company Air Source America Office Phone 904-233-8831 Fax 904-485-8788
Co. Address: 207 20th Street N City Jacksonville Beach State_fj_ "Lip 32250
License Holder(Print): Jason Buehler State Certitication/Registration # CAC 1816716
Notarized Signature of License Holder
r
Before me th' 9th day of .tan 9
�i KURT EICHMANN
+f Y'. Notary Public State of Florida Signature of Notary Public
�` Commission N GG 267633
'tor r< My Comm.Expires Oct 15,2022
Bonded through National Notary Assn.