475 PALMWOOD LN - HVAC .� , :� CITY OF ATLANTIC BEACH
rj s) 800 SEMINOLE ROAD
J' ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
MECHANICAL HVAC PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-MECH-2153
Job Type: MECHANICAL HVAC ONLY
Description: 1 ci 1 ahu 4 tons
Estimated Value:
Issue Date: 9/17/2015
Expiration Date: 3/15/2016
PROPERTY ADDRESS:
Address: 475 PALMWOOD LN
RE Number: 172020-0194
PROPERTY OWNER:
Name: NELLIS, RICHARD E
Address: 475 PALMWOOD LN
GENERAL CONTRACTOR INFORMATION:
Name: SERVICE EXPERTS
Address: 8475 WESTERN WAY STE 100 QA CAREY ZARM
Phone: - -
PERMIT INFORMATION: Sticker for overcurrent protection must be on A/C equipment prior to
inspection. Failure to comply will result in a failed inspection and reinspect fees. No
exceptions.
FEES:
Furnaces and Heating $24.00
AC and Refrigeration $32.00
State Mech DBPR Surcharge $2.00
State Mech DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Total Payments: $115.00
I'I;R\IIT IS APPROVED O\I.V IN ACCORDANCE AFITII A1.I, CI'1'V OF ATLAN(IC IWACII ORDINANCES AND Till: FLORIDA
BUILDING'CODES.
MECHANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233 ,� i1 ��' •
Ph(904) 247-5826 Fax (904) 247-5845 Z ( 53
fOB ADDRESS: W r7 ,5 PPQ LT 0 /i4Ad €' PERMIT# _
PROJECT VALUES l 4 3 �-- ARI# 59 V773 / REQUIRED
Air Handling Equipment Only Air Handling Unit & Condenser Condenser
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 1 Tons Per Unit
Heat: Unit Quantity t BTU's Per Unit f po c2 Seer Rating g D 0
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
Gas 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 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
)is 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
ot. 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 Naive 4/ C//4-/? ) toe Ili c- Phone Number 4,2. / "7 6 /73
Mechanical Comp Service Experts) Office Phone 271-2182 Fax
Co. Address: 8475 Western Way Suite 100 City Jacksonville State Fl, Zip 32256
License Holder(Print): Carey Zarm tate Certificatio egistration# CAC 1817129
Notarized Signature of License Holder ,,,49. .._.._
Before me this 7 day of _._,,, • '-..J ' 20 /5
A' , ,,
MY col l A. oas Signature of Notary Public �1 -�....,.�i►--
,i..ii EXPIRES:July 6,2018
"IRS.f!i.;,% 6onded 11w Notary Public Underonters
Z!Z LELO9P9t'o6 slaadx aciNas Ad co:9g:1 gi•oi;lol/daS
NOTICE OF COMMENCEMENT
•
. (PREPARE IN DUPLICATE) •
• Permit No. Tax Folio No.
State of FL.O/LI DA County of l2(4 VA- L •
. To whom it may concern:
. The undersigned hereby informs you that improvements will be made to certain real property,and in
accordance with Section 713 of the Florida Statutes,the following information is stated in this NOTICE OF• •
COMMENCEMENT. ,r Q .Q I
Legal description of properly being improved: 3 ti- Sf/' 6 /q - Q S-
Sf i-1A ma-..1.1 $) 4- Li iv T--
Address of property being improved: "1 ? S I g I-h'1 tr.) a 06 k 04 N P
/4-7- l,,sA.7,-/ c. 4 e4 e- V F a- 3
. ' General description of improvements: •• I Y 14 C. e�D
•
Owner ILL C .04-kD ive l� / S
• Address q7 S . pgLcn L)von LA) AT-L,QN-Tie 0-eAc^//FL.„3? 3
Owner's interest in site of the improvement 6 (.•) /lie,/ -
• Fee Simple Titleholder(if other than owner) •
Name .
Address
r4. . Contractor rp e.ni(// C•,P e4,f'rpf1�.5
Address gL 7 S L,1 t�s-7—€.i/J !.)/ c�'u/ /Tit° )OO^�► W-X FL 3.tea S4
Phone No. 6p Y / " 93 3 3 Fax No. 4f 6 v ' 7 -
Surety(if any) •--•
Address Amount of bond S •
Phone No. Fax No. ..
Name and address of any person making a loan for the construction of the improvements.
Name
Address .
Phone No. Fax No. -
Name of person within the State of Florida,other than himself,designated by owner upon whom notices or other
documents may be served:
Name
Address g' i;
Phone No. Fax No. •''4,,t,
g'
In addition to himself,owner designates the following person to receive a copy of the Lienor's Notice as provided in cl
Section 713.06(2)(b),Florida Statutes.(Fill in at Owner's option). Y. i
a
Name $n 8 T
Address a g 33
Phone No. Fax No. • it p,_n
. Expiration date of Notice of Commencement(the expiration • one(1)year from the date of recording unless a 15; r
different date is specified):
THIS SPACE FOR RECORDER'S USE ONLY 'OWN?
g/L/
Signed: . II. D TE f/V/,Z�
• Before me this G day o .p.f.%._ in4he l
CounJJ��of Duval.Stale of Flori•-.has%erson illy gpeared
• 1 C. LQ-��.s N c / ( e herein by
Doc#2015209094,OR BK 1 7296 Page 2196, himse herself and affirms that all statements and decla alions herein - •
Number Pages: 1 are true and accurate
Recorded 09/11/2015 at 10:12 AM,
Ronnie Fussell CLERK CIRCUIT COURT DUVAL 97
COUNTY .
RECORDING$10.00 Notary Pubic at Large.State of Ft,, ountyof L
My commission expires: 4.'7 .S
Personally Known or•
.@
Produced Identification A L -=.....--
1