171 Jackson Rd ACRS19-0077 HVAC permit MECHANICAL RESIDENTIAL HVAC PERMIT NUMBER
ACRS19-0077
PERMIT
CITY OF ATLANTIC BEACH ISSUED: 3/12/2019
EXPIRES: 9/8/2019
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORM TO THE CURRENT ISTH 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.
F--
JOB ADDRESS: PERMITTYPE: DESCRIPTION: VALUE OF WORK:—i
171 JACKSON RD MECHANICAL RESIDENTIAL replace 2.5-ton 27.8K-BTU $3327.00
HVAC AHU
TYPE OF REALESTATE BUILDING USE
ZONING: SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
1721290200 DONNERS S/D PT LOT 2
17-
COMPANY: ADDRESS: CITY: STATE: ZIP:
Elite AC, LLC 6060 Chester Circle JACKSONVILLE FL 32217
ADDRESS: STATE: ZIP:
D & L ENTERPRISES LLC 13925 HUNTERWOOD RD JACKSONVILLE FL 32225-1905
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.
7 7,
7
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
AC AND REFRIGERATION 45S-0000-322-1000 2.5 $16.00
FURNACES AND HEATING 455-0000-322-1000 27800 $24.00
MECHANICAL BASE FEE 4SS-0000-322-1000 0 $55.00
STATE DBPR SURCHARGE 4SS-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 4SS-0000-208-0600 0 $2.00
Issued Date: 3/12/2019 1 of 2
PERMIT NUMBER
MECHANICAL RESIDENTIAL HVAC
ACRS19-0077
PERMIT
ISSUED: 3/12/2019
CITY OF ATLANTIC BEACH EXPIRES: 9/8/2019
TOTAL:$99.00
Issued Date:3/12/2019 2 of 2
MECHANICAL PERNHT APPLICATION
CITYOF AT"NTIC BEACH
800 Sminole Rd Atlantic Beach,FL 32233
Pb (904)247-5826 Fax(904)247-5845
JoBADDRFss: . -\T-)\ naftnql ) RC;?k6- - PERMIT# Ae CLS(9 -CC)
PROJECT VALUE$ "D� "b It,') -Q-0 ARI* -1 V151%_2a REQUIRED
Ak Handling Equipment Only _�ZAJr Handling Unit&Condenser Condenser Only
NEW AIR CONIMTIONING & BEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity_ Tons Per Unit
Heat: UnitQuantity— BTU'sPerUnit Scer Ratinp.
Duct Systems: TOW CFM REQEUED
REPLACENTENT ,kIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity Tons Per Unit 1) - �5
Heat: Unit Quantity I BTU's Per Unit 13 Scer Rating— IA
Duct Systems: Total CFN REQUIRED
FIRE PREVENTION
Fire SprhWer System Quantity (Requires 3 sets of plans)
Fire Standpipe Ouantity (Requires 3 sets of plans)
Underground Fire Main Value (Requires 3 sets of plans)
Fire Hose Cabinets Quantity (Requires 3".,of plans)
Commercial Hoods Quantity (Requlru�3 sefd of Plans)
Fire SuppreWon Systenls Quantity (Requires 3 st4 ofplarts)
FM PIACES NUSCELLANEOUS:
Prefabricated Fireplace Qty_ Automobile Lifts
Gas Piping Outleu Boilers BTU's
Elevators/Escalators
ALL OTRER GAS PIPING Heat Exchanger
Quantity of Outlets Pumps
#VenW Wall Furriaces Refrigerator Condenser BTU's
#Water Heaters Solar Collection Systems
Tanks(gallons)
Wells
Peardt bgwnzs void ifuxA does not commence within a sit month period or Aork-is mLVezded or abandoned for six months.I hereby W-tily that I haNT read
thts*Wwsfim and kww the samic to be truc aW catem Ali provwkw of laws and ardinam goveming ft wort wW be complied vntb wbcd=specified or
not The pmM does not give vitharay to violate the provisions of any other state or local law Tegulation conmcuon or the performance of construction.
Property Owners Name 7S��,,j - -e '!�, --
\ - Pbone Number �lyk D%
IMechanical Company I�k (�SL \1� Office Phone?P13 461117ax
Co.Address: ��)Ay-- zi firy State�:L,Zip
License Holder O"nt): 6,0�per 7L-- r:;- 6-12!!�/��ta.k-Certificatim�R4"ion#
Notarfted Signature of Lieense Holder
NNA M, WILLIAMS efore rrne th s 12- day of ~C- 2Q t
Nctary pilblic,swe o!Florid2q
iensture of Notary Public Qn*%
�40mrzisslan Numv GC-902.1
Cash Register Receipt Receipt Number
City of Atlantic Beach R8408
DESCRIPTION ACCOUNT PAID
QTY
PermitTRAK $99.00
ACRS19-0077 Address: 171 JACKSON RD APN: 172129 0200 $99.00
MECHANICAL $95.00
MECHANICAL BASE FEE 455-0000-322-1000 $55.00
AC AND REFRIGERATION 455-0000-322-1000 3 $16.00
FURNACES AND HEATING 455-0000-322-1000 27800 $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
ITOTAL FEES PAID BY RECEIPT: R8408 $99.00
Date Paid: Tuesday, March 12, 2019
Paid By: Elite AC, LLC
Cashier: CT
Pay Method: CREDIT CARD 002815
Printed:Tuesday, March 12,2019 3:28 PM 1 of 1