332 4th St GSRS19-0052 Piping MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
GSRS19-0052
PERMIT
ISSUED: 6/20/2019
Qj 19 CITY OF ATLANTIC BEACH EXPIRES: 12/17/2019
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORM TO THE CURRENT 6TH EDITION (2017) OF THE FLORIDA BUILDING
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE 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.
JOBADDRESS: PERMITTYPE: DESCRIPTION: VALUE OF WORK:
GAS PIPING - FIREPLACE,
332 4TH ST MECHANICAL RESIDENTIAL GAS SUMMER KITCHEN, WATER $1470.00
HEATER & RANGE
TYPE OF REALESTATE BUILDING USE
--CONSTRUCTION: NUMBER: ZONING: GROUP: SUBDIVISION:
1698160000 ATLANTIC BEACH
COMPANY: ADDRESS: CITY: STATE: ZIP:
AEI INTERNATIONAL CORP. 7709 ALTON AVE JACKSONVILLE FL 32211
OWNER: ADDRESS: CITY: STATE: ZIP:
JOOST STEPHEN 10743 WAVERLY BLUFF WAY JACKSONVILLE FL 32223
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
7Roll off container company must be on City approved list. Container cannot be placed on City right-of-way.
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
GAS PIPING OUTLETS 455-0000-322-1000 2 $10.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 4S5-0000-208-0600 0 $2.00
TANKS GAS OR LIQUEFIED PETROLEUM 455-0000-322-1000 205 $20.00
Issued Date:6/20/2019 1 of 2
MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
GSRS19-0052
PERMIT
ISSUED: 6/20/2019
CITY OF ATLANTIC BEACH
c))jj 9 EXPIRES: 12/17/2019
VENTED WALL FURNACE WATER HEATER UNIT 455-0000-322-1000 2 $10.00
TOTAL:$99.00
Issued Date:6/20/2019 2 of 2
�'Oio M forl
Mechanical Permit Application
R AT
City of Atlantic Beach Building Department
6, 800 Seminole Rd, Atlantic Beach, FL 32233
RS t 9 00 S
Phone: (904) 247-5826 Email: Buildin -Dept(c-Dcoab.uit; PERMIT#:
L
JOB ADDRESS: 45� 1�9 Q
PROJECT VALUE '
Fj NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI#(REQUIRED)
13 Air Handling Equipment Only [3 Condenser Only Air Handling Unit& Condenser
Air Conditioning: Unit Quantity_ Tons per Unit
Heat: U nit Quantity_ BTUs per Unit Seer Rating (REQUIRED)
Duct Systems: Total CFM
17-71REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION AR1#(REQUiRED)
[3 Air Handling Equipment Only E3 Condenser Only E3 Air Handling Unit& Condenser
Air Conditioning: Unit --)uantity Tons per Unit
Heat: Unit Quantity BTU's Per Unit Seer Rating (REQUIRED)
Duct Systems: Total CFM
-E]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)
F-IFIRE PLACES r7 MISCELLANEOUS;
Prefabricated Fireplace (Qty)_ Automobile Lifts
Gas Piping Outlets Boilers BTUs
[_-]ALL OTHER GAS PIPING Elevators/Escalators
Heat Exchanger
Quantity of Outlets —L Pumps
#Vented Wall Furnaces Refrigeratbr Condenser BTUs
#Water Heaters Sclar Collection Systems
Tanks (gallons)
Wells
MOTHER: C?(A
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 this app;1,-ation and know the same to be true and correct. All provisions of laws and ordinances governing this
work will be complied with whether:,pecified or not. The permit does not give authority to violate the provisions of any other state or
local law regulation constructioln or theperformance of construction.
Owner Name: Phone Number:
Mechanical Company: ii
A Of"ce Phone:
nil Faxjs)!�-�- Z:
Co. Address: Nl�."
City: 4j,(--MA�t4 State�4.,Zip:�-.
License Holder: Stat Certification/Registration# C19 11-1
Notarized Signature of V ense Holder
The foregoft instrument was acknowledged before me this "�a\y of k- \UV"q-- 20-�i in the State of Florida,
County of Signature of Notary Pt
Notary Pub4ic state of Florida
S tephanie E Carter
ed , = [�(Personally Known OR Produced Identification
C GG 239425
my Commission GG 239425
E_d E.pres 0711812022 Type of Identification:
Updated 1019118
Cash Register Receipt Receipt Number
City of Atlantic Beach R9356
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $99.00
GSRS19-0052 Address: 332 4TH ST APN: 169816 0000 $99.00
MECHANICAL $95.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
GAS PIPING OUTLETS 455-0000-322-1000 2 $10.00
VENTED WALL FURNACE WATER HEATER 455-0000-322-1000 2 $10.00
UNIT
TANKS GAS OR LIQUEFIED PETROLEUM 455-0000-322-1000 205 $20.00
STATE SURCHARGES $4.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL FEES PAID BY RECEIPT: R9356 $99.00
Date Paid: Thursday,June 20, 2019
Paid By: AEI INTERNATIONAL CORP.
Cashier: CB
Pay Method: CREDIT CARD 4
Printed:Thursday,June 20,2019 11:42 AM 1 of 1