1512 Jordan St ACRS19-0226 HVAC MECHANICAL RESIDENTIAL HVAC PERMIT NUMBER
ACRS19-0226
PERMIT
ISSUED: 6/26/2019
9i CITY OF ATLANTIC BEACH EXPIRES: 12/23/2019
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:
1512 JORDAN ST MECHANICAL RESIDENTIAL HVAC - 1 A/C, 1 AHU, 3 TON $3430.00
HVAC
TYPE OF REALESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
1722950030 ED SMITH S/D
COMPANY: ADDRESS: CITY: STATE: zip:
OWNER: ADDRESS: CITY: STATE: ZIP:
Duncliff Trading Company 4240 FULTON AVE #112 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.
L
ISTOFCONDITIONS
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 45S-0000-322-1000 3 $24.00
FURNACES AND HEATING 455-0000-322-1000 36000 $24.00
MECHANICAL BASE FEE 4S5-0000-322-1000 0 $5S.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2001
STATE DCA SURCHARGE 45S-0000-208-0600 0 $2.00
TOTAL: $107.00
Issued Date: 6/26/2019 1 of 2
Mechanical Permit Application "ALL INFORMATION
HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED,
800 Seminole Rd, AtIcantic Beach, FL 32233 1 oz
Phone: (904) 247-5820 [mail: 111pilding-Dept@Cciab.us PFRMIT U:
JOB ADDRtSS: �'S`12-Jonlan St Alianlic Beach, FL :12233---- PROJECT VALUE $3.430 00
j INLW AIR CONDITIONING & HEATING SYSTEM INSTALLATION A RI#(REQUIRED)_
0 Air Handling Equipment Only 0 Condenser Only El Air Handling Unit& Condenser
Air Conditioning: Unit Quantity Tons per Unit
Heat� Unit Quantity HI Us per Unit Seer Rating (REQUIRED)__-
Duct Systems: Total CFM
REPLACE ME NT AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI#(REQUIRED) 9680812
Air Hondling I quipment Only El Condenser Only 0 Air Handling Unit& Condenser
Air Conditioning: Unit Quantity I Tons per Unit 3,0
Heat: Unit Quantity I BIU's Per Unit 36 Seer Rating (RFQUIRED) 14.00
Duct Systems: Total CI-M
"-]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)
[-ire Suppression Systems Quantity (Requires 3 sets of plans)
[—]FIRE PLACES F�MISCELLANEOUS:
Prefabricated Fireplace (Qty)___ Automobile I ifts
Gas Piping Outlets Boilers BTUs
Elevators/F scalators
ALL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets Pumps
;4 Vented Wall Furnaces Refrigerator Condenser B F Us
# Water Heaters Solar Collection Systems
Tanks (gallons)
wells
f-JOTHER:
M
Permit becomes void if work does not commence within a six month period or work is suspenclod or abandoned for six months I hereby
certify that I have read this application and know the sarne to be true and correct. All provisions of laws and ordinances governing this
work will be complied with whether specified or riot, The permit does not give authority to violate the provisions of any other state of
local law regulation construction or the performance of construction.
owner Name:[)un(;Iiff Trading Company Phone Number: (866)970-9295
Mechanical Company: island Breeze Heating&Air,Inc, Office Phone: (904)349-6087 Fax
Co.Address: 4102 Maggie Lane City: Middleburg State: FIL Zip: 32068
License Holder: Robert Kikendall State Certification/Registration# CAC1818508
Notarized Signature of License Holder
The foregoing instrument was acknowledged before me thisiJ-1 day of 20 10, in the State of Florida,
County of jC—\dilj -- - -- <:i -%---
Signature of Notary Public _7
PATRICL4k SLIMP I.-TTersonally Known OR Produced Identification
cownwim#GG 119W4 Type of identification:
Exom ApA 2.2M
w7dared
Cash Register Receipt Receipt Number
City of Atlantic Beach R9408
DESCRIPTION ACCOUNT CtTy PAI D
PermitTRAK $107.00
ACRS19-0226 Address: 1512 JORDAN ST APN: 172295 0030 $107.00
MECHANICAL $103.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
AC AND REFRIGERATION 455-0000-322-1000 3 $24.00
FURNACES AND HEATING 455-0000-322-1000 36000 $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: R9408 $107.00
Date Paid: Wednesday, June 26, 2019
Paid By: Duncliff Trading Company
Cashier: CB
Pay Method: CREDIT CARD 3
Printed:Wednesday,June 26,2019 11:13 AM 1 of 1