122 6th St GSRS19-0035 Fireplace °� '• MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
GSRS19-0035
PERMIT ISSUED: 4/22/2019
�1t CITY OF ATLANTIC BEACH EXPIRES: 10/19/2019
INSPECTIONMUST CALL . f • FOR DAY INSPECTION.
ALL WORK MUST CONFORMTO THE CURRENT 6TH EDITIONt OF
CODE, OF • • 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: VALUE OF WORK:
1226TH ST MECHANICAL RESIDENTIAL GAS GAS FIREPLACE $2926.00
TYPE OF REALESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
170149 0000 ATLANTIC BEACH
COMPANY: ADDRESS:
SETZERS& COMPANY 7660 PHILLIPS HWY JACKSONVILLE FL 32241
• ADDRESS:
HITE JEFFREY A 122 6TH ST ATLANTIC BEACH FL 32233-5316
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 455-0000.3221000 1 $2400
MECHANICAL BASE FEE 455-0000322-1000 0 $55.00
STATE DEER SURCHARGE 4550000-208-0700 0 $200
STATE DCA SU RCHARGE 455-0000-208-0600 0 $200
TOTAL:$83.00
Issued Date:4/22/2019 1 of
ALL
r " INFORMATIONMechanical Permit Application HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
q 800 Seminole Rd, Atlantic Beach, FL 32233S(��
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:
JOBADDRESS: 122 c#N tel- 47IAA %h- 13,%a Rt 9WA PROJECT VALUE$
❑NEW AIR CONDITIONING &HEATING SYSTEM INSTALLATION ARI#(REQUIRED)
o Air Handling Equipment Only ❑ Condenser Only o 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 oCondenser Only p 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
El 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)_J_ Automobile Lifts
Gas Piping Outlets Boilers BTUs-
Elevators/Escalators
❑ALL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets Pumps-
#VentedWallFurnaces Refrigerator Condenser BTUs
#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. ]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: , w`�r" ;PhoneNumber: -7/0-E9 T2.
Mechanical Company: w+a R' A"10 c " VY J^�' Office Phone:�M)-L[I—C? Fax 730,56t13�
i
Co.Address Vi9c, A/ )z &,•,y qtr F! 322-( City:. :. SS.. : State:jg_Zip:�12.f'6
License Holder:IP�GB/t�,Rr)(3Grrr5 State Certification/Registration#I 3oS'Woa
Notarized Signature of License//////Holder:
The foregoin rtrument wayacknowledged before me this of U int State of Florida,
Countyof. \\
Signature of Notary Public
TOWCINotEs7tRCER ersonally Known OR[ ] Produced Identification
Myppngls,, FEIZRI1 Type of Identification:
:� j+� EITIPEs:October 0,2019 UpdnRd10/9/18