500 ROYAL PALMS DR ACRS18-0278 HVAC PERM MECHANICAL RESIDENTIAL HVAC PERMIT NUMBER
ACRS18-0278
PERMIT
ISSUED: 3/26/2019
CITY OF ATLANTIC BEACH
EXPIRES: 9/22/2019
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.
—F
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
500 ROYAL PALMS DR MECHANICAL RESIDENTIAL 3 Ton 33.2K BTU New Unit $3800.00
HVAC
TYPE OF REALESTATE BUILDING USE
ZONING: SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
ROYAL PALMS UNI
1715130000 02A3.00
COMPANY: ADDRESS: CITY: STATE: ZIP:
WHITLEYS HEATING AND 6299 -16 P POWERS AVE JACKSONVILLE FIL 32217
AIR LLC
OWNER: ADDRESS: CITY: STATE: ZIP:
SCARPA GRACE PO BOX 49012 JACKSONVILLE FL 32240
BEACH
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 4S5-0000-322-1000 1 $8.00
FURNACES AND HEATING 455-0000-322-1000 1 $24.00
MECHANICAL BASE FEE 4S5-0000-322-1000 0 $S5.00
Issued Date: 3/26/2019 1 of 2
MECHANICAL RESIDENTIAL HVAC PERMIT NUMBER
ACRS18-0278
PERMIT
ISSUED: 3/26/2019
CITY OF ATLANTIC BEACH EXPIRES: 9/22/2019
STATE DBPR SURCHARGE 455-OWO-208-0600 0 $2.00
STATE DCA SURCHARGE 45500002080700 0 $2.00
TOTAL:$91.00
Issued Date:3/26/2019 2 of 2
MECHANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904)247-5826 Fax(904)247-5845
JOB ADDRESS: 500 &Mal ROL1415 -Z)U- PERmrr#A C-,&Y-t)z7,y
.0
PROJECT VALUE$ 3800 ARI# REQUIRED
Air Handling Equipment Only JLAir Handling Unit & Condenser Condenser Only
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
Air Conditioning: Unit Quantity I Tons Per Unit
Heat: Unit Quantity I BTU's Per Unit Seer Rating
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
Elevatom/Escalators
ALL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets Pumps
# Vented Wall Furnaces Reffigerator Condenser BTU's
4 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 he 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 6rat-& 5--arva- Phone Number Ao4--"S'(0,%(.5
4904-
Mechanical Company *-ft4nA dk-� �4,r, LIL.0 Office Phone�74,jo
j!j!>j Fax
Co. Address: -35-11 15kAL�qus-fivlr Isq— city Ite- Statefl- Zip3z?/-�
License Holder(Print): i�Amllrclro liku State Certi fication/Registration#04, 191
Notar* d S nf * der
q-ITLiLcl 014 041C.
.-----,,I"— I
4000(4c Notary Public Sta�'of Fl�nd;.
ta"' or'
Debra Scheibe efore me this day of 20
sa
m
y Commission GG 19086A
P. I I C)
ignature of Notary Public
Expires(0)1612712022
Cash Register Receipt Receipt Number
City of Atlantic Beach R85 53
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $91.00
ACRS18-0278 Address: 500 ROYAL PALMS DR APN: 171513 0000 $91.00
MECHANICAL $87.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
AC AND REFRIGERATION 455-0000-322-1000 1 $8.00
FURNACES AND HEATING 455-0000-322-1000 1 $24.00
STATE SURCHARGES $4.00
STATE DBPR SURCHARGE 455-0000-208-0600 $2.00
STATE DCA SURCHARGE 45500002080700 0 1 $2.00
TOTAL FEES PAID BY RECEIPT: R8553 $91.00
CITY-Cf-P'kT[AN`l1C BEACH
800 SEIVINCLE RD
ATLANTIC BEAC,Fl.32233
03/26/2019 12:28:49
CREDIT CARD
VISA SALE
Card# XX)XVJ=0525
SEQ#: 6
Bakh#: 819
INVOICE 7
Approval Code: 092306
Enty WW mmi
Mode: Onlix
Tax kwt: $0.00
Avs Code: NYZ
Card Cok m
SAIE AMOUNT 1911
CUSTCHER COPY
Date Paid: Tuesday, March 26, 2019
Paid By: WHITLEYS HEATING AND AIR LLC
Cashier: CB
Pay Method: CREDIT CARD 092306
Printed:Tuesday, March 26,2019 12:34 PM 1 of I