465 Inland Way GSRS19-0064 Piping MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
PERMIT GSRS19-0064
ISSUED: 7/30/2019
„19; CITY OF ATLANTIC BEACH EXPIRES: 1/26/2020
INSPECTIONMUST CALL PHONE (9 04) PM FORINSPECTION.
ALL WORK MUST CONFORMTO THE CURRENT 6TH EDITION1 OF • ' i BUILDING
CODE, ' OF • 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: VALUEOF WORK:
465 INLAND WAY MECHANICAL RESIDENTIAL GAS GAS PIPING - POOL, GRILL $1500.00
AND FIREPIT
TYPE OF
• :D •
• • GROUP:
169463 1537 OCEANWALK UNIT 04
• ADDRESS:
AEI INTERNATIONAL CORP. 7709 ALTON AVE JACKSONVILLE FL 32211
OWNER: ADDRESS:
NEWBERN AMY T 465 INLAND WAY 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.
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 5 $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:7/30/2019 1 of 2
'"*ALL INFORMATION
rsr uv;*T, Mechanical Permit Application HIGHLIGHTED IN
J �'\ City of Atlantic Beach Building Department GRAY IS REQUIRED,
800 Seminole Rd, Atlantic Beach, FL 32233 G15PIS 19 —00G4
°a 0, Phone: (904) 247-5826 Email: Building-Dept coab.us PERMIT:
JOB ADDRESS: 465 Inland Way PROJECT VALUE $1,500.00
❑NEW 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 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
❑ALL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets 3 Pumps
#Vented Wall Furnaces Refrigerator Condenser BTUs
# Water Heaters Solar Collection Systems
Tanks (gallons)
Wells
OTHER: Gas piping to gas pool heater,grill and firepit
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:Bosco Builders Phone Number: 233-0904
Mechanical Company: AEI Gas Services Office Phone: 724-9771 Fax721-3350
Co. Address: 7709 Alton Ave City: Jacksonville State: FI Zip: 32211
License Holder: State Certification/Registration "( (
Notarized Signature of License Haider �it/urt
The foregoi nstrume t was acknowledged before me this' �la o ' 20�`int Sta of Florida,
County of
Signature of Notary Public 1` _
�N
�ps+� Notary Public State of Flonaa ersonaliy Known OR [ ] Produced Identification
Stephanie E Carter Type of identification:
My Commission GG 239425
ja^� Expires 07'1912022 Updated 10/9/19
i Cash
Y sJ Register
City of Atlantic Beach
DESCRIPTION
• CITY PAID
PermitTRAK $69.00
GSRS19-0064 Address: 465 INLAND WAY APN: 169463 1537 $69.00
MECHANICAL $65.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
GAS PIPING OUTLETS 455-0000-322-1000 3 $10.00
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 . • 11
Date Paid: Tuesday, July 30, 2019
Paid By: AEI INTERNATIONAL CORP.
Cashier: LE
Pay Method: CREDIT CARD 4
lot
Printed:Tuesday,July 30, 2019 2:31 PM 1 of 1
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