341 11th St ACRS19-0047 HVAC permit MECHANICAL RESIDENTIAL HVAC PERMIT NUMBER
PERMIT ACRS19-0047
ISSUED: 2/13/2019
CITY OF ATLANTIC BEACH EXPIRES: 8/12/2019
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.
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: DESCRIPT-ION-:-- VALUE OF WORK:
341 11TH ST MECHANICAL RESIDENTIAL replace 3-ton AHU $6500.00
HVAC
TYPE OF REALESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
1701050000 ATLANTIC BEACH
COMPANY: ADDRESS: CITY: STATE: ZIP:
LEGGETT HEATING & AIR 660 KING ST JACKSONVILLE FL 32204
OWNER: ADDRESS: CITY: STATE: ZIP:
STEIN DEBRA A 341 11TH ST ATLANTIC BEACH FL 32233-5531
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.
0
DESCRIPTION ACCOUNT QUANTITY PAIDAMOUNT
AC AND REFRIGERATION 455-0000-322-1000 3 $24.00
FURNACES AND HEATING 455-0000-322-1000 36000 $24.00
MECHANICAL BASE FEE 4SS-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
TOTAL:$107.00
Issued Date:2/13/2019 1 of 2
MECHANICAL RESIDENTIAL HVAC PERMIT NUMBER
PERMIT ACRS19-0047
CITY OF ATLANTIC BEACH ISSUED: 2/13/2019
cm �A, EXPIRES: 8/12/2019
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Issued Date:2/13/2019 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 PERFVIIT#: A 0 �_S icl -0 0
JOB ADDRESS: 341 11 th Street PROJECT VALUE $6,500.00
71 NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI#(REQUIRED)
11 Air Handling Equipment Only [3 Condenser Only El Air Handling Unit& Condenser
Air Conditioning: Unit Quantity Tons per Unit
Heat: Unit Quantity BTUs per Unit Seer Rating (REQUIRED)
Duct Systems: Total CFM
F-1 REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI#(REQUIRED) 8657048
[]Air Handling Equipment Only 0 Condenser Only El Air Handling Unit& Condenser
Air Conditioning: Unit Quantity 1 Tons per Unit 30
Heat: Unit Quantity 1 BTU's Per Unit Seer Rating (REQUIRED) 15.00
Duct Systems: 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 F7MISCELLANEOUS:
Prefabricated Fireplace (Qty)_ Automobile Lifts
Gas Piping Outlets Boilers BTUs
Elevators/Escalators
7ALL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets Pumps
# Vented Wall Furnaces Refrigerator Condenser BTUs
# Water Heaters Solar Collection Systems
Tanks (gallons)
Wells
F—IOTHER:
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 the provisions of any other state or
local law regulation construction or the performance of construction.
owner Name:Debbie Stein Phone Number: (904)742-3694
Mechanical Company: Leggett Heating&Air Conditioning,Inc. Office Phone: (904)384-2612 — Fax
Co. Address: 660 King Street City: Jacksonville State: Fl Zip: 32204
License Holder: Billy Warlitner State Certification/Registration tt CMC057167
Notarized Signature of License Holder /141,yyi/�
7
The foregoing instrument was acknowledged before me this /.�) day of 20 in the State of Florida,
coun-1 _ / Signature of Notary Public
Eou Mffch 2Z V/fpersonally Known OR Produced Identification
Bor,ded#n Am NoWy Type of Identification:
Updated 1019119
Cash Register Receipt Receipt Number
81 City of Atlantic Beach R8135
DESCRIPTION ACCOUNT CITY PAID
PermitTRAK $107.00
ACRS19-0047 Address: 341 11TH ST APN: 170105 0000 $107.00
MECHANICAL $103.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
AC AND REFRIGERATION 455-0000-322-1000 3 $24.00
FURNACES AND HEATING 455-0000-322-1000 36000 $24.00
STATE SURCHARGES $4.130
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: R8135 $107.00
Date Paid: Wednesday, February 13, 2019
Paid By: LEGGETT HEATING &AIR
Cashier: CT
Pay Method: CREDIT CARD 06387G
Printed:Wednesday,February 13,2019 10:23 AM 1 of 1