569 TIMBER BRIDGE LN MECH GAS PERM MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
PERMIT GSRS19-0015
ISSUED: 2/14/2019
CITY OF ATLANTIC BEACH EXPIRES: 8/13/2019
MUST CALL INSPECTION • •NE LINE (904) 2+ + BY + 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: PERMITTYPE: DESCRIPTION: VALUE OF WORK:
569 TIMBER BRIDGE LN MECHANICAL RESIDENTIAL GAS GAS PIPING - FIREPIT $800.00
TYPE OF
-CONSTRUCTION:- GROUP:
169505 2055 ATLANTIC BEACH
COUNTRY CLUB UNIT 02
COMPANY: ADD' '
JOHNSON'S TRACTOR & 86077 MACAW RD YULEE FL 32097
PIPING INC
_• ® ADDRESS:
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.
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
GAS PIPING OUTLETS 455-0000-322-1000 1 $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 4S5-0000-208-0600
Issued Date: 2/14/2019 1 of 2
MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
S� � F
GSRS19-0015 F
PERMIT ISSUED: 2/14/2019
CITY OF ATLANTIC BEACH EXPIRES: 8/13/2019
TOTAL: $69.00
Issued Date:2/14/2019 2 of 2
"ALL INFORMATION
Mechanical Permit Application HIGHLIGHTED IN
, j City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 G1 SRS(9 0c>[J
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:
JOB ADDRESS: �1� , /'/��c'l �l N4 1 f1 . PROJECT VALUE $ Y C'Z�
❑NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI#(REQUIRED)
❑ Air Handling Equipment Only ❑ Condenser Only ❑ 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)
❑ Air Handling Equipment Only ❑ Condenser Only ❑ Air Handling Unit& Condenser
Air Conditioning: Unit Quantity Tons per Unit
Heat: Unit Quantity BTU's Per Unit Seer Rating (REQUIRED)
Duct Systems: Total CFM
❑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)
F—]FIRE PLACES ❑ 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
❑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 the provisions of any other state or
local law regulation construction or the performance of construction.
Owner Name: Phone Number:
1 i � /`,Office Phon r� Y13--01jLI Fax
Mechanical Company: .1;;ltnSCItS I�cr�l>>r Io1�U
Co. Address: ��i� c '' tity: YtA IL State: Zi 3
License Holder: rt >iA AS ate Certification/Registration#
Notarized Signature of License Holder
The foregoin trument vias acknowledged efore a this d y o , 20 in the State of Florida,
County of
Signa ure of Notary ublic
S Y TONI GINRESPERGFF
tdYCOMMIS;IGriJF 951 _- ersonally Known OR [ ] Produced Identification
?�
:9.
EYc� nc 1,�,zo�9 Type of Identification:
Underwriters Updated 10/9/18