1912 Oak Circle ACRS19-0232 duct work permit MECHANICAL RESIDENTIAL HVAC PERMIT NUMBER
ACRS19-0232
PERMIT ISSUED: 7/25/2019
CITY OF ATLANTIC BEACH EXPIRES: 1/21/2020
MUST CALL INSPECTION PHONE LINE (904) 247-581MITWFOR NEXT DAY INSP06N.
I 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.
ENOTICE: In addition to the requirements of this permit,there may be additional restrictions applicable to this property
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hat may be found in the public records of this county, and there may be additional permits required from other
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overnmental entities such as water management districts, state agencies,or federal agencies.
JOB ADDRESS: PERMITTYPE: DESCRIPTION: VALUE OF WORK:
1912 OAK CIR MECHANICAL RESIDENTIAL HVAC - DUCT WORK ONLY $3000.00
HVAC
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TYPE OF REALESTAT BUILDING USE
ZONING: SUBDIVISION:
CONSTRUCTION: NUMBER. GROUP:
SELVA MARINA UNIT
1720201254 12A
COMPANY: ADDRESS: CITY: STATE: ZIP:
D F M MAINTENANCE LLC 3352 TENNIS HILLS LANE JACKSONVILLE FL 32277
OWNER: ADDRESS: CITY: STATE: ZIP:
COOK THOMAS J 1912 OAK CIR ATLANTIC BEACH FL 32233-4506
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.
Roll off container company must be on City approved list . Container cannot be placed on city right-of-way.
171
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
AIR DUCT SYSTEM 455-0000-322-1000 1400 $20.00
MECHANICAL BASE FEE 4S5-0000-322-1000 $SS.00
STATE DBPR SURCHARGE 455-0000-208-0700 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$79.00
issued Date: 7/25/2019 1 of 2
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PERMIT NUMBER
MECHANICAL RESIDENTIAL HVAC
-0232
ACRS19
PERMIT ISSUED: 7/25/2019
CITY OF ATLANTIC BEACH EXPIRES: 1/21/2020
Issued Date: 7/25/2019 2 of 2
"ALL INFORMATION
A Mechanical Permit Application HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
7`1
800 Seminole Rd, Atlantic Beach, FL 32233
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Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: 4&
JOB ADDRESS: jq[,-) C)4k, Ct(,, PROJECTVALUE $
NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI#(REQUIRED)
13 Air Handling Equipment Only El Condenser Only [3Air Handling Unit& Condenser
Air Conditioning: Unit Quantity Tons per Unit
Heat: Unit Quantity BTUs per Unit Seer Rating (REQUIRED)
Duct Systems: Total CFM 0
[—]REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI#(REQUIRED)
[I Air Handling Equipment Only IM Condenser Only E3 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 /goo
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 r7 MISCELLANEOUS:
Prefabricated Fireplace (Qty)_ Automobile Lifts
Gas Piping Outlets Boilers BTUs
Elevators/Escalators
F�ALL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets Pumps
#Vented Wall Furnaces Refrigerator Condenser BTUs
#Water Heaters Solar Collection Systems
Tanks (gallons)
Wells
f-�OTHER: wu(-L OKLA -�j V,)-c
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: :]-,V\-OAA.C6 Phone Number: 579 1-5'32-f-
Mechanical Company: VV\d�rN:�vicwtc-Q- [-L,(�, Office Phone:.C60(4-4-5/-3310 Fax
Co. Address: '-�359, -T'e-aV\(S �Kils City: * soylut.16 State: r-C Zip: 37Z-7
License HoIder:—( ,u-C-s ArJ��o Att'cen _S�ate Certifi tion/Registration# C/qiC,1915-617q
Notarized Signature of License Holder (/'- '/
The foregoing instrument was acknowledged before me this �01day of C�(.�k 2,R)4(
,jflin-th State of Florida,
County of
Signature of Notary Public
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EXPIRES April 10,2020 Type of Identification:
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1407)il"-0153 _:Fk)11daN0tUrYSe1V Updated 1019118
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Cash Register Receipt Receipt Number
City of Atlantic Beach R9680
DESCRIPTION ACCOUNT CITY PAID
PermitTRAK $79.00
ACRS19-0232 Address: 1912 OAK CIR APN: 172020 1254 $79.00
MECHANICAL $75.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
AIR DUCT SYSTEM 455-0000-322-1000 1400 $20.00
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: R9680 $79.00
Date Paid:Thursday, July 25, 2019
Paid By: D F M MAINTENANCE LLC
Cashier: CT
Pay Method: CREDIT CARD 073528
Printed:Thursday,July 25,2019 12:47 PM I of I