1673 ATLANTIC BEACH DR GSRS19-0017 GAS PERMIT MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
GSRS19-0017
PERMIT
ISSUED: 3/7/2019
CITY OF ATLANTIC BEACH EXPIRES: 9/3/2019
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:
1673 ATLANTIC BEACH DR MECHANICAL RESIDENTIAL GAS install 6 gas-piping outlets $0.00
TYPE OF REALESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
ATLANTIC BEACH
1695051360 COUNTRY CLUB UNIT 02
_C_-0---M P-A T
NY: ADDRESS: CITY: STATE: ZIP:
AEI INTERNATIONAL CORP. 7709 ALTON AVE JACKSONVILLE FL 32211
ZIP:
OWNER: ADDRESS: CITY: STATE:,
LAURA COLEY
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
iRoll off container company must be on City approved list . Container cannot be placed on City right-of-way.
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
GAS PIPING OUTLETS 455-0000-322-1000 6 $14.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $SS.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $73.00
issued Date: 3/7/2019 1 of 2
Mechanical Permit Application "ALL INFORMATION
HIGHLIGHTED IN
GqAy IS REQUIRED.
City of Atlantic Beach Building Department
C, Beach, FL 32233
800 Semincle Rd, Atlanti b.us PERMIT#:
Phone: (904) 247-5826 Email: Buildin -De t �ucoa UE $
PPOJECT VAL
JOB ADDRESS: lalilf—
F-1 NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION API#(REQUIRED) & Condenser
0 Air Handling Equipment Only E3 Condenser Only [I Air Handling Unit
Air Conditioning: Unit Quantity Tons per Unit Seer Rating (REQUIRED)
Heat: Unit Quantity BTUs per Unit
Duct Systems: Total CFM
REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION Affl#(REQUIRED)
[3 Air Handling Equipment Only C3 Condenser Only C3 Air Handling Unit& Condenser
Air Conditioning: Unit Qua.n,1-ity__ TonsperUnit
Heat: Unit Quantity BTU's Per Unit Seer Rating (REQUIRED)
Duct Systems: Total CFM
L]FIRE PREVENTION
Fire Sprinkler System Quantity (Requires 3 sets of plans)
Fire Standpipe Quantity (Requires 3 sets of plans)
Underground Fire Main Value (Requ;res 3 sets of plans)
Fire Hose Cabinets Quantity (Requires 3 sets of plans)
Commercial Hoods Quantity (Requires 3 sets of plans)
Fire Suppression Systems Ql!antity (Requires 3 sets of plans)
17FIRE PLACES r7 MISCELLAINIEOUS;
Prefabricated Fireplace (Qty,_- Automobile Lifts
Gas Piping Outlets Boiler-,� BTUs
Elevato-'-s/Escalators
r--jALL OTHER GAS P:PING Heat Exchanger
Quantity of Outlets 3 Pumps
#Vented Wall Furnaces Refrigerator Cordenser BTUs
# Water Heaters Z Solar Collection Systems
Tanks (gallons)
Wells
HER.Olk-66M to (2-) wwwrwt-or "Coov-toQ, C)Ncr , C�V-eome ar'd Owl.
I" M--- - -
Permit becomes void if work do-s noi-commence within a six month period or work is Suspended or abandoned for six months. I hereby
certify that I have read this applicatior, ::nd krow the same to be true and correc+. All provi-�ions of laws and ordinances governing this
work will be complied with whether spccified or not. The permit does not Rive authority to violate the provisions of any other state or
local law regulation construction or the performance of construction.
Owner Name: 9ZW7Tr Phone Number: -16011 04125
M ec h a n i c a I C o m p a n y: &0 ffi c e P h o n e:
12 �!��17 '-
F a x-72 k 3-2f)C
Ci
Co. Address: "1-?0T7' Aftv�f�--Ave-, ty State: IF zip:
i—Awl -41
License Holder: State Certification/Registration#
Notarized Signature of License Ho
Ider
The foregoin nstrument wa- acknowledged before me thisZ day of
i t,20 in the State of Florida,
9 r If=Z,
County of
k, SignpAure of Notary Public
R 40 09% Notary PubhC State of Flonda [�4�ersonally Known OR Produced Identification
stephame E Carter
my Commomon GG 239A25 Type of Identification:
V1.1d; Expires 07/iS12022
Or
E I Updated 1019118
Cash Register Receipt Receipt Number
City of Atlantic Beach R8365
DESCRIPTION ACCOUNT CITY PAID
PermitTRAK $73.00
GSRS19-0017 Address: 1673 ATLANTIC BEACH DR APN: 169505 1360 $73.00
MECHANICAL $69.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
GAS PIPING OUTLETS 455-0000-322-1000 6 $14.00
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: R8365 $73.00
Date Paid:Thursday, March 07, 2019
Paid By: AEI INTERNATIONAL CORP.
Cashier: CT
Pay Method: CREDIT CARD 7266
Printed:Thursday, March 07,2019 2:35 PM 1 of 1