536 Beach Avenue ACRS19-0074 HVAC permit MECHANICAL RESIDENTIAL HVAC PERMIT NUMBER
PERMIT ACRS19-0074
ISSUED: 3/11/2019
CITY OF ATLANTIC BEACH EXPIRES: 9/7/2019
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 AD RIESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
536 BEACH AVE MECHANICAL RESIDENTIAL 2-TON 24K-BTU AHU 800 $8725.00
HVAC CFM DUCT SYS.
TYPE OF REALESTATE BUILDING USE
ZONING: SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
1701460000 ATLANTIC BEACH
COMPANY: ADDRESS: CITY: STATE: ZIP:
ROGERS AIR CARE 20 HAWORTH AVE JACKSONVILLE FL 32216
SERVICES
011,110 1 111� ADDRESS: CITY: STATE: ZIP:
SHERMAN LEAH 536 BEACH AVE ATLANTIC BEACH FL 32233
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 $16.00
AIR DUCT SYSTEM 455-0000-322-1000 800 $20.00
FURNACES AND HEATING 455-0000-322-1000 24000 $24.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
Issued Date: 3/11/2019 1 of 2
PERMIT NUMBER
MECHANICAL RESIDENTIAL HVAC
SS
PERMIT ACRS19-0074
ISSUED: 3/11/2019
,cm CITY OF ATLANTIC BEACH EXPIRES: 9/7/2019
STATE DCA SURCHARGE 4SS-0000-208-0600 0 $2.00
LTOTAL:$119.00
Issued Date:3/11/2019 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 tkc "(61 —00T(-t
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT M RE511- 04-33
JOB ADDRESS: 6,-r& 3ft-ACM /9-04-40L% PROJECTVALUE $
�NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI#(REQUIRED) ?,5�
El Air Handling Equipment Only 0 Condenser Only A-Alir Handling Unit& Condenser
Air Conditioning: Unit Quantity Tons per Unit a
Heat: Unit Quantity BTUsperUnit cj%oog Seer Rating (REQUIRED) I&
Duct Systems: Total CFM 700
F1 REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI#(REQUIRED)
0 Air Handling Equipment Only El Condenser Only El Air Handling Unit& Condenser
Air Conditioning: Unit Quantity Tons per Unit IF'
Heat: Unit Quantity BTU's Per Unit Seer Rati ??t,
Duct Systems: Total CFM U
FIRE PREVENTION rn
Fire Sprinkler System Quantity (Requires 3 sets of plans) MAR 1 1 2019
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 planspuf1rd"ng Department
Commercial Hoods Quantity (Requires 3 sets of plfm
,4)f of At'anldc Beach, Ft
Fire Suppression Systems Quantity (Requires 3 sets of plaQ
F-]FIRE PLACES F-1 MISCELLANEOUS:
Prefabricated Fireplace (Qty)_ Automobile Lifts
Gas Piping Outlets Boilers BTUs
Elevators/Escalators
DALL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets Pumps
#Vented Wall Furnaces Refrigerator Condenser BTUs
#Water Heaters Solar Collection Systems
Tanks (gallons)
Wells
F-JOTHER:
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: &I E-,�m4f,� Phone Number:
Mechanical Company: Ry"Re, prifi QAqL- &-poil tkEs -'T(,CDffice Phone: q0L) 1ZI-1 -ZO IS Fax PJ 49-
Co.Address: *0 Wmjpogirti City: NOW-<, State:-k-zip: --SZZ
License Holder: R%CM/kh 'b. RoGeA'�-.p State Certification/Registration# (2AdO 2-Z 951
Notarized Signature of License Holder ----*ay-of �kt� , 20 in the Sltate of Florida,
The forego nstru nt was acknowledged before me thisl d ail
County of_1Wj Signature of Notary Public
JOSETTE A;ETHMEL tion
I [ ] ersonally Kno�wn OR [V4roduced Identi i
Commission#FF 218261 1 1 h�
L
AM:
ExOres April 7,2019 Ty e of Identification: W
ft.—o ThmTmyFdnbwBww$043ffi4W9
Updoted 1019118
J
Cash Register Receipt Receipt Number
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $119.00
ACRS19-0074 Address: 536 BEACH AVE APN: 170146 0000 $119.00
MECHANICAL $115.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
AC AND REFRIGERATION 455-0000-322-1000 2 $16.00
FURNACES AND HEATING 455-0000-322-1000 24000 $24.00
AIR DUCT SYSTEM 455-0000-322-1000 800 $20.00
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: R8388 $119.00
Date Paid: Monday, March 11, 2019
Paid By: ROGERS AIR CARE SERVICES
Cashier: CB
Pay Method: CREDIT CARD 1112g
00��'
Printed: Monday, March 11,2019 5:15 PM 1 of 1
TRMT