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1607 Atlantic Beach Dr GSRS19-0057 Piping MECHANICAL RESIDENTIAL GAS PERMIT NUMBER r s GSRS19-0057 PERMIT ISSUED: 7/11/2019 X19 CITY OF ATLANTIC BEACH EXPIRES: 1/7/2020 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: 1607 ATLANTIC BEACH DR MECHANICAL RESIDENTIAL GAS GAS PIPING - 2 OUTLETS $300.00 TYPE OF ZONING: :D • • • GROUP: 169505 1065 ATLANTIC BEACH COUNTRY CLUB UNIT 01 COMPANY: ADDRESS: ' AA BOTTLED GAS 12601 N MAIN ST JACI<SONVILLE FL 32218 COMPANY INC • . DMSTATE: TOLL FL VI LIMITED 250 GIBRALTAR RD HORSHAM PA 19044 PARTNERSHIP 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. 77* Roll off container company must be on City approved list . Container cannot be placed on City right-of-way. _1 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 455-0000-208-0600 0 $2.00 Issued Date:7/11/2019 1 of 2 Mechanical Permit Application "ALL INFORMATION ~ m, City of Atlantic Beach Building Department HIGHLIGHTED IN GRAY IS REQUIRED. 800 Seminole Rd, Atlantic Beach, FL 32233 Phone: (904) 247-5826 Email: Building-Dept coab us — PERMIT#: JOB ADDRESS: LO-1 f-�fl(' nti(. PROJECT VALUE $ ❑NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI#(REQUIRED) ©Air Handling Equipment Only El Condenser Only ❑Air Handling Unit& Condenser Air Conditioning: Unit Quantity Tons per Unit Heat: Unit Quantity BTUs per Unit Seer Rating (REQUIRED) Duct Systems: Total CFM REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI#(REQUIRED) ❑Air Handling Equipment Only ❑ Condenser Only ❑Air Handling Unit& Condenser Air Conditioning: Unit Quantity Tons per Unit Heat: Unit Quantity BTU's Per Unit Seer Rating (REQUIRED) Duct Systems: Total CFM ❑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 BTUs Elevators/Escalators FIALL OTHER GAS PIPING Heat Exchanger Quantity of Outlets Pumps #Vented Wall Furnaces Refrigerator Condenser BTUs # Water Heaters Solar Collection Systems Tanks (gallons) Wells BOTHER: 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 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: bn(' L,10 -(.) De- \q'i) �11C. Phone Number: Mechanical Company: On px-,/tl ii w (-� (A _).c 1- Office Phone: n l.t-4' � I _ I -il#ax Co. Address: _D-(c 0 I lLi (,I V } City: _10( ('�C OV I S State:F�Zip: License Holder: ,(t8 r-�,i Ltd A-aw State Certification/Registration tt 305tes Notarized Signature of License Holder )�} The foregoin instrument was acknowledged before me this,)/ �ay of m 1 , in the State of Florida, County of��� Signatu f Notary Public REEfl tata of F!anaa ��rWerrnnendson [ li'1 ersonally Known OR [ J Pr uced Identification GG 339151 T e of Identification: 2023 yp Updated 10/9/18