1820 N Sherry Dr GSRS19-0043 Tank/Outlets MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
4 a GSRS19-0043
p PERMIT ISSUED: 5/13/2019
rs
CITY OF ATLANTIC BEACH EXPIRES: 11/9/2019
INSPECTIONMUST • ' 1 � • DAY INSPECTION.
ALL WORK, LL CONFORMTO THE CURRENT 6TH EDITION1 OF • ' 1A BUILDING
CODE, NEC, IPIVIC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF 1
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.
1 . ADDRESS: • • OF • '
1820 N SHERRY DR MECHANICAL RESIDENTIAL GAS install 250-gal.tank & 3 gas- $3800.00
piping outlets
TYPE OF SUBDIVISION:NG USE
CONSTRUCTION: NUMBER: GROUP:
SELVA MARINA UNIT
1720200776 10B
COMPANY: ADDRESS:
EXPERT GAS APPLIANCE P 0 BOX 338 CALLAHAN FL 32011
SERV CO
• ADDRESS:
YOUNG SARAH L 1820 SHERRY DR N 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
GASPIPING OUTLETS 455-0000322-1000 3 $1000
MECHANICAL BASE EEE 455-0000-322-1000 0 $5500
STATE DERR SURCHARGE 455-0000-20" 00 0 $2'W
STATE DCA SURCHARGE 455-0000208-0600 0 $2'�
Issued Date:5/13/2019 1 oft
MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
PERMIT GSRS19-0043
ISSUED: 5/13/2019
CITY OF ATLANTIC BEACH EXPIRES: 11/9/2019
TRNKS Gl50R LIQUEFIED PETROLEUM 455000P322-1000 250 $20.00
TOTAL:$89.00
Issued Date:5/13/2019 2 of 2
IINFORMATION
Mechanical Permit Application HIGHLIGHTED IN
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#: r1SNl ` �Dy�
JOB ADDRESS: PROJECT VALUE
❑NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI#(REQUIRED)
0 Air Handling Equipment Only 0 Condenser Only 0 Air Handling Unit&Condenser
Air Conditioning: Unit Quantity Tonsper 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 CJ Condenser Only 0 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)
❑FIRE PLACES ❑MISCELLANEOUS:
Prefabricated Fireplace(Qty)_ Automobile Lifts
Gas Piping Outlets Boilers BTUs
Elevators/Escalators
❑ALL OTHER GAS PIPING Heat6¢kanger G.41343-W l8'0.00
Quantity of Outlets 3 F.—Pg S✓Trne2�„'1dn.y/fid eOp
#Vented Wall Furnaces Refrigerator Condenser BTUs
If Water Heaters Solar Collection Systems
Tanks (gallons)
Wetts>�'oo/�h�Q 7r('^innn
MOTHER: 50-fn/ d750 �/yCID�+/t✓Ko/ef.+y Y/iri-/.� /9N.>'LPr+✓ /YP�✓ C..�4c C."l-/r .
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 1 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:-� ��S Yl�w/'.o Phone Number:
Mechanical Company: y1cm2cZ 6;>K�L,Jz.+.r2� „[lffice Phone:�oU1?/9a9_4'Fax--— �y.573
Co.Address: 6Y�/S-2/r $,h..c.!✓ ,f7�j �f City:,Cj�//„g/yp,.� State:�fliliic �b/>
License Holder:..� `a'-95 ��.{.OG�O State Certification/Registration# Z,'
�/.?7�f7
Notarized Signature of License Holder
The foregoin instrument was acknowledged before me this-Iday of 20Ain the State of Florida,
County of
JENNIFERJOHNSTON Signature of Notary Public
?R',q�, � PIYCOMMIa be Mis)2M
y. J eone
EXPIRE
u P p1 1 e 9 [ ] Personally Known OR r oducr DLitication
Type of Identification
updoredio/s/18