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165 PINE ST - HVAC cy `'''�'' MECHANICAL RESIDENTIAL HVAC PERMIT NUMBER #.. .._.) PERMITACRS19-0054 ISSUED: 2/21/2019 CITY OF ATLANTIC BEACH EXPIRES:8/20/2019 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: DESCRIPTION: VALUE OF WORK: 165 PINE ST MECHANICAL RESIDENTIAL replace 2.5-ton 27.4K-BTU $4600.00 HVAC AHU TYPE OF REAL ESTATE ZONING: BUILDING USE j SUBDIVISION: CONSTRUCTION: NUMBER: GROUP: 170635 0130 SALTAIR SEC 03 COMPANY: ADDRESS: CITY: STATE: ZIP: BROWARD FACTORY SERVICE BFS 2071 Emerson St. #16 Jacksonville FL 32207 OWNER: ADDRESS: CITY: STATE: ZIP: SAPIA PETER C TRUST ET 1655 SELVA MARINA DR ATLANTIC BEACH FL 32233-5615 AL 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 AC AND REFRIGERATION 455-0000-322-1000 2.5 $16.00 FURNACES AND HEATING 455-0000-322-1000 27400 $24.00 MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00 STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00 Issued Date: 2/21/2019 1 of 2 %'s-Anric.,, MECHANICAL RESIDENTIAL HVAC PERMIT NUMBER P { �" ' PERMIT ACRS19-0054 .5. CITY OF ATLANTIC BEACH ISSUED: 2/21/2019 �rI �. EXPIRES: 8/20/2019 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00 TOTAL:$99.00 Issued Date: 2/21/2019 2 of 2 0y`1TJrlr� 3:3' t, Cash Register Receipt Receipt Number City of Atlantic Beach R8217 'raft 9; DESCRIPTION I ACCOUNT I QTY I PAID PermitTRAK $99.00 ACRS19-0054 Address: 165 PINE ST APN: 170635 0130 $99.00 MECHANICAL $95.00 MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00 AC AND REFRIGERATION 455-0000-322-1000 3 $16.00 FURNACES AND HEATING 455-0000-322-1000 27400 $24.00 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: R8217 $99.00 Date Paid: Thursday, February 21, 2019 Paid By: BROWARD FACTORY SERVICE BFS Cashier: CT Pay Method: CHECK 65147 /,P, Printed:Thursday, February 21, 2019 12:35 PM 1 of 1 mucn MECHANICAL PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach, FL 32233 (� Ph (904) 247-5826 Fax (904) 247-5845 JOB ADDRESS: \ b c3L Rc h, 3��3 3 PERMIT# PROJECT VALUE $ ��0 0 DC7 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 _ ARI # .R9115 Air Conditioning: Unit Quantity I Tons Per Unit (9. 7 REQUIRED Heat: Unit Quantity I BTU's Per Unit k 14 00 Seer Rating I`-1 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 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. Property Owners Name Te c .thS tT Phone Number Mechanical Company-brew, d Fackvc Set Office Phone 3`It,-4, 1 S Fax?'ib SCO Co. Address: ;01 I l of S on S t t#1w City _,a c Kson v+I I-e State EL- Zip3,37-0`'7 License Holder(Print): Se C c� Le- - • !MM ate C +fica } -- -gistration # 14 C O5(o 7'W Notarized Signature of License Holder 1._.g I ..n.. '�► . .dfillk ZIAA I Sworn And sub.cribed - �m a this 1 1/ say of/ "MY 20/7 MICHELLE K CARLSON ' /1 : My coMMtsstoN$FFa89343 Signature of otary Public f/v EXPIRES February 14.2020 ton) V Fligileflearyfiervia COM Feb 21 19 10:21a P'8 /116911111:11111 CERTIFIED wv:w.ahridirectory.org Certificate of Product Ratings AHRI Certified Reference Number:201629871 Date:02-21-2019 Model Status:Active Old AHRI Reference Number:7489175 AHRI Type:HRCU-A-CB Outdoor Unit Brand Name:RHEEM Outdoor Unit Model Number (Condenser or Single Package):RP1430AJ1 Indoor Unit Model Number(Evaporator and/or Air Handler): RH1T3617STAN The manufacturer of this RHEEM product is responsible for the rating of this system combination. Rated as follows in accordance with the latest edition of ANSI/AHRI 210/240 with Addenda 1 and 2, Performance Rating of Unitary Air-Conditioning&Air-Source Heat Pump Equipment and subject to rating accuracy by AHRI-sponsored.independent,third party testing: Cooling Capacity(A2)-Single or High Stage(95F), btuh:28800 SEER: 14.00 • EER(A2)-.Single or High fir:(95F):11.5.0 , .; ` ' .• : - ' s - Heating Capacity(H12)-Single or High.Stage(47F):27400. ;.; HSPF(Region IV):820 • r'Active"Model Status are those that an AHRI Certification Program Participant is currently producing AND selling or offering for sale;OR new models that are being marketed but are not yet being produced'Produchon Stopped'Model Status are those that an AHRI Certification Program Participant is no longer producing BUT is still selling or offering for sale. Ratings that are accompanied by WAS indicate an involuntary re-rate. The new published rasing is shown along with the previous(i a.WAS)rating. DISCLAIMER AHRI does not endorse the product(s)listed on this Certificate and makes no representations,warranties or guarantees as to.and assumes no responsibility for. the product(s)fisted on this Certificate.AHRI expressly disclaims all liability for damages of any kind arising out of the use or performance of the product(s),or the unauthorized alteration of data listed on this Certificate.Certified ratings are valid only for models and configurations listed In the directory at www,ahrldlrectory.org. TERMS AND CONDITIONS This Certificate and Its contents are proprietary products of AHRL Toils Certificate shall only be used for Individual.personal and confidential reference purposes.The contents of this Certificate may not,in whole or In part,be reproduced;copied:disseminated; entered Into a computer database;or otherwise utilized,in any form or mariner or by any means,except for the user's Individual. personal and confidential reference. AIR•CONOITIONING,HEATING, &REFRIGERATION INSTITUTE CERTIFICATE VERIFICATION The information for the model cited on this certificate can be verified at www.ehridirectory.org,dick on'Verify Certificate'link• „c make life IJeUo and enter the AHRI Certified Reference Number and the date on which the certificate was issued, _ __ _ __-- _ . which is listed above,and the Certificate No..which is listed at bottom right. 13195238315459ti1150 ©2019AIr-Conditioning,Heating,and Refrigeration Institute tr C FICATE NO.: