83 W 9th Street GSRS19-0030 Gas Piping/Tank MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
PERMIT GSRS19-0030
ISSUED:
CITY OF ATLANTIC BEACH EXPIRES:
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 BUILDIN
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF
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,c r federal agencies.
• • . r • • • • OF • '
83 W 9TH ST MECHANICAL RESIDENTIAL GAS GAS PIPING, ONE OUTLET $1400.00
AND 118 GAL TANK
ZONING:TYPE OF REALESTATE SUBDIVISION:BUILDING USE
CONSTRUCTION: NUMBER: GROUP:
170813 0100 ATLANTIC BEACH SEC H
COMPANY: ADDRESS:
FLORIDA PROPANE-Griffis 461 TRESCA RD JACKSONVILLE FL 32225
Gas
• ADDRESS:
BANKS DARYL S 83 9TH ST W ATLANTIC BEACH FL 32233
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
GASPIFwGOUTLETS 455 WOO-322-1000 1 51000
MECHANICAL BASE FEE 455-OWO322-1000 0 $Si.00
STATE care SURCHARGE 455 WOO 20802W 0 $200
STATE DCA SURCHARGE 455-0000-208-0600 0 $200
TANKS GAS OR LIQUEFIED PETROLEUM 455-WOO-322-SOW 118 $20.00
Issued Date: 1 of 2
' MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
PERMIT GSRS19-0030
ISSUED:
CITY OF ATLANTIC BEACH EXPIRES:
TOTAL:$89.00
Issued Date: 2 of 2
"ALL ON
Mechanical Permit Application HIGHLIGHTEDIN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233
'
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:(
JOB ADDRESS: 77 3 UN. q S 1 PROJECT VALUE$ I °IOC7 P�
F-1 NEW AIR CONDITIONING&HEATING SYSTEM INSTALLATION ARI#(REQUIRED)
❑Air Handling Equipment Only ❑ Condenser Only ❑Air Handling Unit& Condenser
Air Conditioning: Unit Quantity Tons per Unit
Heat: ' Unit Quantity BTUs per Unit Seer Rating(REQUIRED)
Duct Systems: Total CFM
❑REPLACEMENT AIR CONDITIONING&HEATING SYSTEM INSTALLATION ARI#(REQUIRED)
❑Air Handling Equipment Only ❑ Condenser Only ❑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
❑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-1 FIRE PLACES ❑ MISCELLANEOUS:
Prefabricated Fireplace(Qty)_ Automobile Lifts
Gas Piping Outlets Boilers BTUs
Elevators/Escalators
❑ALL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets Pumps
#Vented Wall Furnaces Refrigerator Condenser BTUs
#Water Heaters Solar Collection Systems
Tanks (gallons) f
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 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: \ 1 t (e Litn� !n'KS Phone Number. tx CO
Mechanical Company: EI .r a� C',�en6- Pit tTCTS Office Phone: r/o (___7�YN2J� Fax
Co.Address:, 4f f ItrV drL City:C c,L',.+ry2 State: f7— Zip: 3L23.
License Holder. ar at ion/Regist ration If 2r > 06
Notarized Signature of License Holder
The foregoin instru ent was acknowledged be ore me t s�( day of E U ( 'n the ate of Florida,
County of ✓`✓°t -
Signature of Notary Public
;:+,'qp.,, JENNIFER JGHNSTnN [ rsonally Known OR[ ) Produced Identification
MY p GG 06298)
fAMtiir EXPIRES:oMW 2I,9130 Type of Identifications
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