355 W 3rd St. GSRS19-0018 ,I.. �li„, MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
C)5i '�
rt 3' °; PERMIT GSRs19-0018
ISSUED: 2/27/20193 CITY OF ATLANTIC BEACH EXPIRES: 8/26/2019
MUSTCALL INSPECTION$P,HONE LIN go 04) 247=5814BY 490M.FOR NEXT DAY INSPECTIONy •:,,,
ALL WORK,MUST CONFORM TO THE CURRENT 6TH"EDITION OF THE FLORIDA BUILDING
, CODE, NEC, IPMC,AND CITY OF ATLANTIC BEACH°C.ODE 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.
1QBaADDRESS!' °° $ ,• PERMITTYPE: ' 3 , , DESCRIPTION', IVALUE OF WOR¢K 'e
355 W 3 ST MECHANICAL RESIDENTIAL GAS GAS PIPING - 3 OUTLETS ; $600.00
•
TYPE OF REAL.ESTATE BUILDING USE °
ZONING' - .. ° SUBDIVISION:
CONSTRUCTION: .: NUMBER *•.-t..:,•-7,: -,:,:, ROUP:'G . , '. s
.,,. , . .
170873 1000 ATLANTIC BEACH SEC H
COMPANY:. . I ` ADDRESS: , • - ,m .°CITY: ° e STATE: z ZIP:
FIRST QUALITY GAS, INC. P O BOX 16303 JACKSONVILLE FL 1 32246
OWNER: ADDRESS: • • CITY STATE: ' ZIP:
•
BEASLEY GERALDINE ET AL 237 SOUTHERN ROSE DR JACKSONVILLE FL 32225
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.
`'CIST'OF CONDITIONS .?
Roll off container company must be on City approved list. Container cannot be placed on City right-of-way.
x.>. FEES°• • °
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
GAS PIPING OUTLETS 455-0000-322-1000 3 $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 455-0000-208-0600 0 $2.00
TOTAL:$69.00
Issued Date:2/27/2019 1 of 2
0-fq-, . Mechanical Permit Application **ALL INFORMATION
HIGHLIGHTED IN (
� . City of Atlantic'Beach Building Department GRAY-IS REQUIRED.
"I- - 800 Seminole Rd, Atlantic Beach, FL 32233 C SRS( q) -00 ( 8
f *`s¢t" Phone: (904)247-5826 Email: Building-Dept@coab.us PERMIT#:
JOB ADDRESS: b../ ? T 1 PROJECT VALUE$' ,,Iz/.. i
Ti NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI#(REQUIRED)
❑ Air Handling Equipment Only ❑ 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)
❑ 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)
(FIRE PLACES n MISCELLANEOUS:
Prefabricated Fireplace (Qty) Automobile Lifts
Gas Piping Outlets Boilers BTUs
Elevators/Escalators
HALL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets . Pumps
#Vented Wall Furnaces Refrigerator Condenser BTUs
#Water Heaters Solar Collection Systems
Tanks (gallons)
Wells
n 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.' aiSIP$ !Phone Number:. !
Mechanical Company:i r5% (pUc 6'17 Ls-t. S Office Phone:I 'Fax
Co. Address:I ! 1& Xi (n?U� Clty:, r _ `State:/� Zip ,`3�v2i
License Holder: 4� urn Stat- -ertification/Registration# !' p22.
Notarized Signature of License Ho < -•�
r
The foregoin• ' strument , as acknowledged before me this Z.. ay o 1— , O , in e Slate of Florida,
County of ' to
'"" - "''... Signature of Notary Public Q
"` P------------ -
e.):"..1%°1 MY COMMISSION it 1:1-u'_;'.51
,L-, ersonally Known OR [ ] Produced Identification
• �; ' :, EXPIRES:October 6,2019 1�
{ ,c p• 4�' BondedThruNotaryPuclicUnderwriters Type of Identification:
Updated 10/9/18