55 Simmons Rd ACRS19-0121 HVAC mm�MECHANICAL RESIDENTIAL HVAC PERMITNUMBER
PERMIT ACRS19-0121
ISSUED:4/16/2019
D,, ;, CITY OF ATLANTIC BEACH EXPIRES: 10/13/2019
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORMTO THE CURRENT 6TH EDITIONt OF • •
CODE, AND CITY OF • • 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 maybe additional permits required from other
governmental entities such as water management districts,state agencies,or federal agencies.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
55 SIMMONS RD MECHANICAL RESIDENTIAL HVAC-1 A/C, 1 AHU,2 TON $6300.00
HVAC
ZONING:TYPE OF REALESTATE SUBDIVISION:BUILDING USE
CONSTRUCTION: NUMBER: GROUP:
172165 0000 DONNERS R/P
COMPANY: ADDRESS:
ISLAND HEATING AND AC 1146 Hamlet Court Neptune Beach FL 32266
• ADDRESS:
Richard Arthur 55 Simmons 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.
FEES
ACCOUNT QUANTITY PAID AMOUNT
AC AND REFRIGERATION 455-0000.322-1000 2 $1800
FURNACES ANDHEATING 455-0000-322-1000 24000 $2400
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.0
STATE DBPR SURCHARGE 455-0000.208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL$99.00
Issued Date:4/16/2019 1 of 2
MECHANICAL RESIDENTIAL HVAC PERMIT NUMBER
PERMIT ACRS19-0121
ISSUED:4/16/2019
CITY OF ATLANTIC BEACH EXPIRES: 10/13/2019
Issued Date:4/16/2019 2 of 2
MECHANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233
C Ph(904)247-5826 Fax(904)247-5845 AeRs ic� _o 1 z
JOB ADDRESS: S chi MMOAS R PERmrrN
PROJECT VALUE$ 6 f 300 ' a�Q ARI#2o 16 ,j—F9s— REQUIRED
__Air Handling Equipment Only ✓Air Handling Unit& Condenser _Condenser Only
NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity t Tons Per Unit a'd `yQ
Heat: Unit Quantity / BTU's Per UnitSeer Rating
Duct Systems: Total CFM Tae REQUIRED
REPLACEMENT 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
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
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)
Wells
OTHER:
permit becomes void if work does not commenre within a six month period or work is suspended or abandmud for six months.l hereby certify that 1 have teed
this application and know the some to he we and correct. All provisions of laws and ordinances governing this work will be complied with whether specified ur
not. The permit does not give authority to violate the provisions of any other slate or local law regulation construction or the performance of constructionn..
Property Owners Name 2 .ck ,j Adkuf Phone Number V22!/2 ir
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Mechanical Company Zri// J Add5 APJ A;i ��OPPffice Phone333,&-)Y9 Fax
Co.Address: l fc/�t 11,ld (,f City It ellk"le State t'C Zip?IXC-
License Holder(Print): G ✓Vo�— State Certifwtion/Registration#C4Ql?1- ooh,_
Notarized Signature aJLice—Holder �— (5�-
/•.
n ,y afAwrcawlssloattrnrns TMkaoN elPataaisk lefore me this 10 day of QLD - L ) 20 1 C
F e aes:arettsazo 'i nature of Not Public A
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