971 Amberjack Ln GSRS19-0029 gas permit MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
PERMIT GSRS19-0029
ISSUED: 3/29/2019
CITY OF ATLANTIC BEACH EXPIRES: 9/25/2019
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
CODEJ. 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' P E R M I T TYPE: DESCRIPTION: VALUE OF WORK: -i
971 AMBERJACK LN MECHANICAL RESIDENTIAL GAS front porch addition & $515.00
interior remodel
TYPE OF REALESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
1711730000 ROYAL PALMS UNIT 01
COMPANY: I ADDRESS: CITY: STATE: ZIP:
AEI INTERNATIONAL CORP. 7709 ALTON AVE JACKSONVILLE FL 32211
OWNER: ADDRESS: CITY: STATE: ZIP:
LUNDGREN ERIK 971 AMBERJACK LN ATLANTIC BEACH FL 32233-4226
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.
DESCRIPTION ACCOUNT QUANTITY PAIDAMOUNT
GAS PIPING OUTLETS 455-0000-322-1000 1 $10.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 4SS-0000-208-0600 -0 $2.00
TOTAL:$69.00
Issued Date:3/29/2019 1 of 2
MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
GSRS19-0029
PERMIT
ISSUED: 3/29/2019
jilt. CITY OF ATLANTIC BEACH EXPIRES: 9/25/2019
Issued Dite: 3/29/2019 2 of 2
"ALL INFORMATION
Mechanical Permit Application HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED,
800 Seminole Rd,Atlantic Beach, FL 32233 Tja�['I — ()0-�I,,C�
Phone:(904)247-5826 Email: Building-DeptPcoab.us PERMIT#:
7
JOB ADDRESS:-V 2L A-D 19L PROJEcTVALUE$ -5
F-�NEW AIR CONDITIONING&HEATING SYSTEM INSTALLATION ARI#(REQUIRED)
0 Air Handling Equipment Only [3 Condenser Only 0 Air Handling Unit&Condenser
Air Conditioning: Unit Quantity Tons per Unit er Rating(REQUIRED)
Heat: Unit Quantity BTUs per Unit Se
Duct Systems: Total CFM
E-1 REPLACEMENT AIR CONDITIONING&HEATING SYSTEM INSTALLATION ARI#(REQUIRED)
[I Air Handling Equipment Only [3 Condenser Only [3 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
OFIRE 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 MISCELLANEOUS:
Prefabricated Fireplace(Qty)_ Automobile Lifts
Gas Piping Outlets Boilers BTUs
Elevators/Escalators
FIALL 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: .'�e t A)X)Pf4jV"rid 7t1�-j)A- j bfle- tv
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: E r-I' L t,,n �4 Ore IIII&Phone Number: -3-7,24-
Mechanical Company: Cg!CA�f�f - 1�� Office Phone:r7)L44-(4 Irl
1-10C� N�tf\ NVI City:— _Zip-
Co.Address: ,I(�L State:
LicenseHolder: State Certification/Regist ration# q9.
Notarized Signature afticense Holder
The foregoi nstruT t was acknowledged before me this-X6"�ay ofMCUa-\,20 in the State of Florida,
County of 'An
S,
0 ure of Notary Public -
a�PN Notary Publ<StatO of tda
?%a �7Per�'onally Known OR Produced'Identification
stephame E carier .
my GG 2 25
jType of Identification:
E.1-111 07,18,2022
I Updated 10/9/18
Cash Register Receipt Receipt Number
City of Atlantic Beach R8606
DESCRIPTION ACCOUNT CITY PAID
PermitTRAK $143.00
GSRS19-0028 Address: 390 PLAZA APN: 1699810000 $74.00
MECHANICAL $70.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
GAS PIPING OUTLETS 455-0000-322-1000 2 $10.00
VENTED WALL FURNACE WATER HEATER 455-0000-322-1000 1 $5.00
UNIT
STATE SURCHARGES $4.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
GSRS19-0029 Address: 971 AMBERJACK LN APN: 171173 0000 $69.00
MECHANICAL $65.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
GAS PIPING OUTLETS 455-0000-322-1000 1 $10.00
STATE SURCHARGES $4.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SU RCHARG E 455-0000-208-0600 0 $2.00
l�-
TOTAL FEES PAID BY RECEIPT: R8606 $143.00
Date Paid: Friday, March 29, 2019
Paid By: AEI INTERNATIONAL CORP.
Cashier: LE
Pay Method: CREDIT CARD 2
000%
Printed: Friday, March 29,2019 10:28 AM 1 of 1
TO UT