536 Beach Avenue GSRS19-0041 Tank,Heater MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
PERMIT GSRS19-0041
ISSUED:4/30/2019
CITY OF ATLANTIC BEACH EXPIRES: 10/27/2019
MUST CALL INSPECTION PHONE LINE 1904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORMTO THE CURRENT 6TH EDITIONt OF • D
CODE, AND CITY OF ATLANTIC BEACH CODEOF 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,or federal agencies.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
536 BEACH AVE MECHANICAL RESIDENTIAL GAS install 3 gas-piping outlets, $1300.00
100-gal. tank, water heater
ZONING:TYPE OF REALESTATE SUBDIVISION:BUILDING USE
CONSTRUCTION: NUMBER: GROUP:
170146 0000 ATLANTIC BEACH
• ADDRESS: CITY: STATE: ZIP:
SAWYER GAS OF THE 98 PENMAN RD JACKSONVILLE FL 32250
BEACHES BEACH
ADDRESS:
SHERMAN LEAH 536 BEACH AVE 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 PAID AMOUNT
GPS PIPING OUTLETS 455-0000-322-1000 3 $1000
MECHANICAL BASE FEE 455-0000-3221000 0 $5500
STATE DEER SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000.208-0600 0 $2.00
AS
TANKS GOR LIQUEFIED PETROLEUM 4550000.322-1000 U. $20.00
Issued Date:4/30/2019 1 of 2
Cash Register Receipt Receipt Number
City of Atlantic Beach • 11
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DESCRIPTION ACCOUNTCITY PAID
PermitTRAK $94.00
11
GSRS19-0041 Address: 536 BEACH AVE APN: 170146 0000 $94.00
MECHANICAL $90.00
MECHANICAL BASE FEE 455-0000.322-1000 0 $55.00
GAS PIPING OUTLETS 455-DWO-322-1000 3 $10.00
TANKS GAS OR LIQUEFIED PETROLEUM 455-0000-322-1000 IW $20.00
VENTED WALL FURNACE WATER H EATER 455-0000-322-1000 1 $5.00
UNIT
STATE SURCHARGES $4.00.!
STATE DBPR SURCHARGE 455-0000208-0700 0 $2.W
STATE DCA SURCHARGE 455-0000-208-0600 0 $2'00
TOTALPAID 911 $94.00
Date Paid:Tuesday,April 30,2019
Paid By:SAWYER GAS OF THE BEACHES
Cashier: CT
Pay Method:CREDIT CARD 038763
Printed:Friday,May 10,2019 9:09 AM 1 Of 1
MECHANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(9044)247-5826 Fax (904)247-5845 OOL{/
Ion ADDRESS: 153G 1edGt-,� ANe PERMIT#
PROJECT VALUE$ I I ZOO ARI N REQUIRED
_Air Handling Equipment Only _Air Handling Unit& Condenser _Condenser Only
NEW 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
REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity Tons Per Unit
Heat: Unit Quantity BTU's Per Unit Seer Ratio@
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 QtyAutomobile Lifts
Gas Piping Outlets Boilers BTU's
Elevators/Escalatom
ALL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets 1_ Pumps
#Vented Wall Furnaces Refrigerator Condenser BTU's
#Water Heaters Solar Collection Systems
Tanks(gallons)
Wells
OTHER:
°errnit 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
his 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
,at. The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name ('IPxlalf'IPS V%yn lLP r`lI'l :�_�Qhone Number qWb-56149
Mechanical Company S �SCaS Office Phone 2R(r5fg00_Fax '�-4Gg4
Co. Address: City',SWjjra , StateFL Zip 32,SO
License Holder(Print): C Slate Certification/Registration# SLI
LI
Notarized Signature of License Holder _
JOHN E MARDI Beforeme this � day of
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Erpiresnay 25,2021 Signature of Notary PtrE.ls��f
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