1793 E Park Terr GSRS19-0061 Piping Int Remodel MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
GSRS19-0061
PERMIT
ISSUED: 7/22/2019
CITY OF ATLANTIC BEACH EXPIRES: 1/18/2020 I
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 • ' + BUILDING
CODE, AND OF ATLANTIC + CH CODE OF ORDINANCES .
ALL i • OF PERMIT APPLY, PLEASE READ + .
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.
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• ADDRES!kl
PERMIT TYPE: DESCRIPTION: OF • '
1793 E PARK TER MECHANICAL RESIDENTIAL GAS GAS-PIPING OUTLET FOR $150.00
INTERIOR REMODEL
TYPE OF •
ZONING: . r •
• • GROUP:
� 172020 0418 SELVA MARINA UNIT 08
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P' ADDRESS:
SAWYER GAS OF THE 98 PENMAN RD JACKSONVILLE FL 32250
BEACHES
EAA}}C,,HHE�ES�� BEACH
NIEMCZYK TODD R 225 SHERRY DR ATLANTIC BEACH FL 32233-5237
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 1 $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
TOTAL:$69.00
Issued Date: 7/22/2019 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
JOB ADDRESS: mq , Paf\L -T-er PERMIT# 0-1 S - Vk
PROJECT VALUE $ 1'50 - ()Q 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 Pumps
#Vented Wall Furnaces Refrigerator Condenser BTU's
# Water Heaters Solar Collection Systems
Tanks (gallons)
Wells
OTHER:
?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 violate the provisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name MP qan 01 AC-2- L Phone Number
\,lechanical Company S10 -Mer ACA Office Phone;C�Q MGFax
�. Citmkx State Zip ZZ
F 1
i¢e$se Holder Pxi State Certification/Registration# 30S'*A
'1aJizl ;' tatureOr
License Holder
SO .4 r�
;t:�//'/' •• 111' U0,16 o � Before me this U day / til 20I_
/���� i;c�. A:Mlo k"N`\ Signature of Notary Public