1800 SEVILLA BLVD ACRS18-0173 HVAC PERM APP l800 Sev( hcQg �
INVOICE #
City of Atlantic Beach INV-3922
r' 800 Seminole Road Date Due: 5/27/2018
Atlantic Beach, FL, 32233
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OCEAN STATE HEAT&AIR,INC.
1476 ATLANTIC BLVD
CIA JAMES GLENN JONES
NEPTUNE BEACH, FL 32266
Invoice Date:4/27/2018
Record# Record Type Fee Group Fee Description Quantity Amount
ACRS18-0173 MECHANICAL RESIDENTIAL MECHANICAL AC AND REFRIGERATION 4 $32.00
HVAC FURNACES AND HEATING 1 $24.00
MECHANICAL BASE FEE 0 $55.00
STATE SURCHARGES STATE DBPR SURCHARGE 0 $2.00
STATE DCA SURCHARGE 0 $2.00
$115.00
Invoice Total:$115.00
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Please send your payment to this address:
Printed: Friday,April 27,2018 11:12 AM 1 of 1 j
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04/27/2018 07 : 55 FAX 9042498949 OCEAN-STATE-A/C ATLANTIC-BEACH 1a001/003
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MECHANICAL PERMIT APPLIC,A,TION
CITY OF ATLANTIC ]BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph (904)247-5$26 Fax (904) 247-5845
JOB ADDRESS: �. ����. l}J• PF.RNn•r#
PROJECT VALUE$�
Air Handling Equipment Only Air Dandling 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- _ Tons Per Unit LA
Heat: Unit Quantity BTU's per Unit ooh Seer Ratin �-�
Duct Systems: Total CFM &"�'V_ REQUIRED
FIRE PREVENTION
Fire Sprinkler System Quantity (Requires 3 sets of plans)
Fire Standpipe Quantity (Requires 3 sets oflana
Underground Fire Main Value (Requires 3 sets of plans)
Fire Hose Cabinets Quantity (Requires 3 sets of plans)
Commercial bloods 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
Elevators/Escalators
ALL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets Pumps
# Vented Wall Furnaces Refrigerator Condenser BTU's
# Water Heaters Solar Collection Systems
Tanks (gallons)
j Wells
1
OTHER:
Permit beeomcs void if work does not cotttmcncc within a six month period or work is suspended or abandoned for six.months,I hcrt by certify that 1 have read
this application and know the same to be true and correct, All provisions orlaws and ordinances governing this work will hi.complied with whether"allied ur
not, The permit docs not give autho 'y to viol r the Provisions o any other state or local law gelation construction or the performance of construction.
Property Owners Name V 1 a- C-0y) �l Y111f 11rV1�S Phone Number (��3?3-QI 3j0rl
Mechanical Company d" Office Phone Fax
Co_Address: LI
City AgAf2k State L Zip;1
License Holder(Print): r Certification/Registration# 77
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Notarize F ere o License Hil,
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YVEM P,MORALEi t1 da of 20
sNopryPuiNlc-SWteofFf e fhiS y(OMM11419M l rda 0691.MYC?Mm,tepinyMagg tune of Notary Public—CA..0 111 V7j A—