1280 W Plaza GSRS19-0036 Fireplace MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
J l PERMIT GSRS19-0036
ISSUED:4/22/2019
CITY OF ATLANTIC BEACH EXPIRES: 10/19/2019
PHONEMUST CALL INSPECTION • r • FOR NEXT DAY INSPECTION.
CODE, . CITY OF . .
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:
1280 W PLAZA MECHANICAL RESIDENTIAL GAS GAS FIREPLACE $5665.00
TYPE OF REALESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
170979 0000 ATLANTIC BEACH SEC H
COMPANY: ADDRESS:
SETZERS &COMPANY 7660 PHILLIPS HWY JACKSONVILLE FL 32241
• ADDRESS:
BROWN JAMES W 4012 RUSTLING OAKS CT JACKSONVILLE FL 32277
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 PAID AMOUNT
FURNACES AND HEATING 455-0000-332-1000 1 524AG
MECHANICAL BASE FEE 455-0000-322-1000 0 $5500
STATE DBPR SURCHARGE 455-0000-208-07M 0 $200
STATE DCA SURCHARGE 455-0000-208-0600 0 $200
TOTAL:$83.00
Issued Date:4/22/2019 1 of 2
ALL
rINFORMATIONMechanical Permit Application HIGHLIGHTEDIN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 G S FS((�._ 003(P
Phone: (904) 247-5826 Email: Building-Dept(a7coab.us PERMIT#:
JOB ADDRESS: SO t.J . P)AaA .4A% f,?61da FL 32233 PROJECT VALUE$��LS��
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
El 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)
Fir uppression Systems Quantity (Requires 3 sets of plans)
FIRE F LACES ❑ 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
IF Water Heaters Solar Collection Systems
Tanks(gallons)
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: T`M 1� t.�ti Phone Number:
Mechanical Company: SEhz[�Y -dC Nnxlluv '.pre. Office Phone: 7B),yl(bO Fax
1 I
Co.Address: 76�r6D phlile s City: SAY State: PL Zip: 322x6
License Holder: p@QR R State Certification/Registration# 30sxo
Notarized Signature of License Holder
The foregoing i ment was aeknowledged before me this in he State of Florida,
County of
Signature of Notary Pubd c
GIN,,'16 FGEP
Mr cou#16INUEFsz<951Personally Known OR ]Produced Identification
,�; EXPIRES:oclober 6.2019 Type e of Identification:
'.fed:„b`: eoaa.ory w�rr Nb.u�dio.e Updated 10/9/18