133 Beach Ave GSRS19-0055 Piping MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
r GSRS19-0055
�r PERMIT ISSUED:
x,rl:19, CITY OF ATLANTIC BEACH EXPIRES:
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL • 'K MUST CONFORM TO THE CURRENT 6TH EDITION1 OF • ' D+ BUILDING
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL • i OF PERMIT APPLY, / + D 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: PERMITTYPE: DESCRIPTION: VALUE OF WORK:
133 BEACH AVE MECHANICAL RESIDENTIAL GAS GAS PIPING - 7 OUTLETS & 3 $1800.00
WATER HEATERS
TYPE OF
ZONING: : • •
• • GROUP:
170213 0000 ATLANTIC BEACH
COMPANY: ADDRESS:
SAWYER GAS OF THE 98 PENMAN RD JACKSONVILLE FL 32250
BEACHES BEACH
• ADDRESS:
SCROGINS WILLIAM C 2000 CHEROKEE DR NEPTUNE BEACH FL 32266
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 • •
Roll 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 7 $16.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 45S-0000-208-0600 0 $2.00
VENTED WALL FURNACE WATER HEATER UNIT 455-0000-322-1000 3 $15.00
Issued Date: 1 of 2
MECHANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904) 247-5826 Fax(904) 247-5845
TOB ADDRESS: 133 hack C4�1nc,*oc� �--L 32233 PERMIT#
PROJECT VALUE $ 1$O0 .O O ARI# REQUIRED
Air Handling Equipment Only Air Handling Unit & Condenser Condenser Only
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 Tons Per Unit
Heat: Unit Quantity BTU's Per Unit Seer Rating
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 _7 Pumps
#Vented Wall Furnaces Refrigerator Condenser BTU's
# Water Heaters 5 Solar Collection Systems
Tanks (gallons) 500 Ion
Wells
ETHER:
?ermit 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
:his 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
iot. The permit does not give authority to Aviolate the provisions ofapy other state or local law regulation construction or the performance of construction.
Property Owners Name vv ll�4 �X `R� C C.) Phone Number
Mechanical Company S1yUJU1 QK 6K, o t' t�,s, Office Phone 100D Fax 730 %'Ogtl
—o. Address: 6 � K(� City`�jj��RV11\ �StateL Zip
State Certification/Registration# 30S yL4
6iKS J HOLLOWAY
�''zl�ffl9ilc a Holder
Commission#FF e96938
MY Comm.Expires Jul 18,2019 Before met s t _day C- 20
."
'' ft*d ftO*WOW Notary MA ( /
�iunat�rre nfNotary Public 0.4.E dL1(riY