1852 Hickory Ln ACRS19-0189 Replacement MECHANICAL RESIDENTIAL HVAC PERMIT NUMBER
ACRS19-0189
PERMIT ISSUED: 5/31/2019
CITY OF ATLANTIC BEACH EXPIRES: 11/27/2019
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
[NOTICE' I"8ddito"to he regun,,ements of this permit,there may be additional restrictions applicable to this property
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that may bfoumd In the public records of this county,and there may be additional permits required from other
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governmental entities such as water management districts,state agencies,or federal agencies.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
1852 HICKORY LN MECHANICAL RESIDENTIAL replace 2-ton AHLI $4200.00
HVAC
TYPE OF REALESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
SELVA MARINA UNIT
1720201454 12C R/P
COMPANY: ADDRESS: CITY: STATE: ZIP:
WAYCHOFFS AIR 6929 S PHILLIPS PARKWAY DR JACKSONVILLE FL 32256
CONDITIONING
OWNER: ADDRESS: CITY: STATE: ZIP:
WHITE JOHN W JR 1852 HICKORY LN 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 ORAN
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
DESCRIPTION
AC AND REFRIGERATION 455-0000 322-1000 2 $16,00
FURNACESAND HEATING 455� ),322-1000 24003 $24,00
MECHANICAL BASE FEE 455-MM 322-1000 0
S'TAT' ENESURC. ADC
TATE CRIME SURCHARGE 455 000�208 0700 0
issued Date: 5/31/2019 1 of 2
MECHANICAL RESIDENTIAL HVAC PERMIT NUMBER
ACRS19-0189
PERMIT ISSUED: 5/31/2019
CITY OF ATLANTIC BEACH EXPIRES: 11/27/2019
STATE DCA SURCHMGE $2.W
TOTAL:$99.00
issued Date:S/31/2019 2 of 2
MECHANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233
Ph(904)247-5826 Fax(904)247-5845
JoBADDREss: IPSA ke-k2fy twie PERrmT# AO-f�S IQ-
PROJECTVALUE$ %?00-0) ARI# ToWi _MQUIRED
_.Air Handling Equipment Only _LAir Handling Unit & Condenser _Condenser Only
NEW AIR CONDITIONING &HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity Tom Per Unit —
Heat: Unit Quantity BTU's Per Unit Seer Rating—
Duct Systems: Total CFM REQU1RED
REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity Tons Per Unit -a
Heat: Unit Quantity BTU's Per Unit Seer Rating— /7
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
Oas 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 be..void if work does not cormosence within a six month period or work is suspended or abandoned for six noonfle,I hereby cestify,that I have read
this application and know the same to be true and carrecl. 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 my other state or local law rsg.liia cranamation or the performance of construction.
Property OwnersName 7okn 4-)ht,4e- PhoneNumber
Mechanical Company U—&%Ac,95 24L Office Phon*969A2--"axj&-:-
Co.Address: State lz�
—J�a7m( -:�7`t(hU Cityj�CaE,5cvz& p
License Holder(Print): 3i6\.,i QQ14C.1,-%T'X State Certification/Registmtion#CAC)9136n
NoAvizedSignature ofLiceme Holder
Rachel Marshall Before me this 3 1 dayof MC 20 11
NOTARY PUBLIC
STATE OF FLORIDA Signature of Notary Public -96el%,s�
Comm#GG304195
Expires 2/20/2023
Cash Register Receipt Receipt Number
City of Atlantic Beach R9202
DESCRIPTION A:CCO CITY PAID
_ :LINT
PermitTRAK 99.00
ACRS19-0189 Address: 1852 HICKORY LN APN: 172020 1454 $99.00
MECHANICAL $95=
MECHANICALBASE FEE 455-0000 322-1000 $55.00
ACAND REFRIGERATION 455-0000-322-1000 2 !:w
!$121
FURNACESAND HEATING 455-0000-322-1000 24)00 1
SrATESURCHARGES $4.
12
STATE DBPR SURCHARGE 455-00CK-208-0700 0 T
2070
STATE DCA SURCHARGE 455-000C-208-0W 1 0
TOTAL FEES PAID BY RECEIPT: R9202 $99.00
Date Paid: Friday, May 31, 2019
Paid By:WAYCHOFFS AIR CONDITIONING
Cashier:CT
Pay Method: CREDIT CARD 03304G
Printed:Friday,May 91,2019 4:22 PM 1 of 1