292 16TH ST ACRS19-0087 HVAC/DUCT WORK PERM MECHANICAL RESIDENTIAL HVAC PERMIT NUMBER
ACRS19-0087
PERMIT
ISSUED: 3/27/2019
CITY OF ATLANTIC BEACH EXPIRES: 9/23/2019
MUST CALL INSPECTION PHONE LINE (904) 247-q814 BY 4 PM FOR NEXT DAY INSPECTION.1�1'
ALL WORK MUST CONFORM TO THE CURRENT 6TREDITION (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: VALUEOFWORK:
292 16TH ST MECHANICAL RESIDENTIAL ADD DUCTWORK TO $2300.00
HVAC ADDITION
TYPE OF REALIESTATE BUILDING USE
ZONING.
SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
1703850000 ATLANTIC BEACH PRKWY
#02
ADDRESS:
COMPANY: CITY: STATE: ZIP:
HAMMOND AIR 3412 GALILEE RD JACKSONVILLE FL 32207
CONDITIONING INC
OWNER: ADDRESS: CITY: STATE: ZIP:
DAY JEFFREY E 292 16TH ST ATLANTIC BEACH F1 32233
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMM ENCEM ENT 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.
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
AIR DUCT SYSTEM 4SS-0000-322-1000 $20.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $S5.00
STATE DBPR SURCHARGE 4SS-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 52.00
Issued Date:3/27/2019 1 of 2
MECHANICAL RESIDENTIAL HVAC PERMIT NUMBER
ACRS19-0087
PERMIT
ISSUED: 3/27/2019
CITY OF ATLANTIC BEACH EXPIRES: 9/23/2019
TOTAL: $7
Issued Date: 3/27/2019 2 of 2
**ALL INFORMATION
Mechanical Permit Application
HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:
JOB ADDRESS: �1, PROJECT VALUE
NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI#(REQUIRED)
Li Air Handling Equipment Only Ei Condenser Only El Air Handling Unit& Condenser
Air Conditioning: Unit Quantity Tons per Unit
Heat: Unit Quantity BTUs per Unit Seer Rating (REQUIRED)
Duct Systems: Total CFM
FIREPLACEIVIENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI#(REQUIRED)
Li Air Handling Equipment Only Li Condenser Only Ll Air Handling Unit& Condenser
Air Conditioning: Unit Quantity Tons per Unit
Heat: Unit Quantity BTU's Per Unit Seer Rating(REQUIRED)
Duct Systems: Total CFM
EI 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)
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
Rd3
Le(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 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: HR Asa bo-�-, Phone Number: 110-i-
Mechanical Company: Office Phonel)�tj.-S�a Fax
Co. Address: City: Zpcyb"i-lk- State:Fl--. Zip:317-0-1
License Holder: 3kA.6ov HAMPC*t,�b state certification/Registration# 0140-12,1(.45 )
Notarized Signature of License Holder
The foregoipg-m t u en was acknowledged before me this Iftc! f 0 in the State rida,
,s r a-1-�� rl
County of I ) ( - C_
J/
Signature of Notary Public
TON GIND.LESPERGER 4--�Kersonally Known OR Produced Identification
P kbi, #FF 924951
r6 01� Type of Identification:
MyCO3MMjSS10N#FF924951
october 6,2019
EXPIRES t"s
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Updated 1019118
%tary pu,jic Underwnters
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Cash Register Receipt Receipt Number
City of Atlantic Beach R8577
01
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $79.00
ACRS19-0087 Address: 292 16TH ST APN: 170385 0000 $79.00
MECHANICAL $75.00
MECHANICAL BASE FEE 455-0000-322-1000 $55.00
AIR DUCT SYSTEM 455-0000-322-1000 $20.00
STATE SURCHARGES $4.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 L�-0-0
TOTAL FEES PAID BY RECEIPT: R8577 $79.00
Date Paid: Wednesday, March 27, 2019
Paid By: HAMMOND AIR CONDITIONING INC
Cashier: LE
Pay Method: CREDIT CARD 6
Printed:Wednesday, March 27,2019 2:25 PM 1 of 1