323 Belvedere St ACRS19-0209 HVAC permit MECHANICAL RESIDENTIAL HVAC PERMIT NUMBER
ACRS19-0209
PERMIT
ISSUED: 6/20/2019
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.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
323 BELVEDERE ST MECHANICAL RESIDENTIAL HVAC - 1 A/C, 1 AHU, ONE $2650.00
HVAC TON
TYPE OF REALESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
1707030270 SEASPRAY
COMPANY: ADDRESS: CITY: STATE. ZIP:
HOLLAND AC & HEATING 5000 -18 H HWY 17 APT 52 ORANGEPARK FL 32003
SERVICE
OWNER: ADDRESS: CITY: STATE: ZIP:
PAUTZ HOWARD 323 BELVEDERE ST ATLANTIC BEACH FL 32233-4110
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
AC AND REFRIGERATION 4SS-0000-322-1000 2 $16.00
FURNACES AND HEATING 455-0000-322-1000 30000 $24.00
MECHANICAL BASE FEE 4SS-0000-322-1000 0 $55.00
STATE DBPR SURCHARGE 4SS-0000-208-0700 0 $2.00
0
4SS-0000-208-0600 0 $2.00
STATE DCA SURCHARGE �00
Issued Date: 6/20/2019 1 of 2
MECHANICAL RESIDENTIAL HVAC PERMIT NUMBER
PERMIT ACRS19-0209
ISSUED: 6/20/2019
CITY OF ATLANTIC BEACH EXPIRES: 12/17/2019
TOTAL:$:9:9:010
Issued Date:6/20/2019 2 of 2
Mechanical Permit Application "ALL INFORMATION
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#:
JOB ADDRESS: 323 6,f /v c-J PROJECT VALUE s 2
_5-�
NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI#(REQUIRED)
1-1 Air Handling Equipment Only 0 Condenser Only 0 Air Handling Unit& Condenser
Air Conditioning: Unit Quantity Tons per Unit
Heat: Unit Quantity BTUs per Unit Seer Rating (REQUIRED)
Duct Systems: Total CFM
F�IREP�ACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION AR- 1,94R
(ro-�Air Handling Equipment Only y Air Handling Unit& Condense—r
A C
C( gCondenser Om
r onditioning: Unit Quantity Tons per Unit
Heat: Unit Quantity BTU's Per Unit ,�, C 6�0 Seer Rating (REQUIRED)
Duct Systems: Total CFM
FIFIRE 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–]FIRE PLACES MISCELLANEOUS:
Prefabricated Fireplace (Qty) Automobile Lifts
Gas Piping Outlets Boilers BTUs
Elevators/Escalators
7ALL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets Pumps
#Vented Wall Furnaces Refrigerator Condenser BTUs
#Water Heaters Solar Collection Systems
Tanks (gallons)
Wells
MOTHER:
Permit becomes void if work does not commence within a six month period or work is sus ended or abandoned for six months. I hereby
certify that I 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: Phone Number:
Mechanical Company: Pc, i c� 4-1 c-- 4-A e- mt Office Phone: Fax
Co.Address: 5U.' J — City: F1rM,',1j5 r�- State: i�(Zip: 32010 3
License Hold --w Oo to.--nA State Certification/Registration# e A06(,'7 12
Notarized Signature of License Holder
20 in the State of Florida,
The foregoin instrument was acknowledged before me this day c,6�,�
County of Mai Signature of Not 14
i ary Publ
NICOLE M.ZILLIVIER
MY COM14ISSION t FF 934746 j Personally Known OR Pl:�,Procluced Identification
V4 EXPIRES:Nmember 17,2019
Type of Identification: EL �1 rk,vcvs
"tOF hr��ed Tn Budpt Notary Seykes Updoted 1019118
Receipt Number
Cash Register Receipt
City of Atlantic Beach R9357
DESCRIPTION ACCOUNT CITY PAID
PermitTRAK $99.00
ACRS19-0209 Address: 323 BELVEDERE ST APN: 170703 0270 $99.00
MECHANICAL $95.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
AC AND REFRIGERATION 455-0000-322-1000 2 $16.00
FU RNACES AN D H EATI NG 455-0000-322-1000 30000 $24.00
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: R9357 $99.00
Date Paid: Thursday, June 20, 2019
Paid By: HOLLAND AC & HEATING SERVICE
Cashier: CB
Pay Method: CREDIT CARD 5
Printed:Thursday,June 20, 2019 11:47 AM 1 of 1