322 4th St ACRS19-0258 I-Vi
MECHANICAL RESIDENTIAL HVAC PERMIT NUMBER
ACRS19-0258
PERMIT
ISSUED: 7/30/2019
CITY OF ATLANTIC BEACH EXPIRES: 1/26/2020
MUST CALL INSPECTION PHONE LINE (904) 247-S814 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:
322 4TH ST MECHANICAL RESIDENTIAL HVAC - 2 A/C, 2 AHU, 2.5 & 3 $12400.00
HVAC TON
TYPE OF REALIESTATE BUILDING USE
ZONING: SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
1698150150 ATLANTIC BEACH
ADDRESS: CITY: STATE: ZIP:
HAMMOND AIR 3412 GALILEE RD JACKSONVILLE FL 32207
CONDITIONING INC
OWNER: ADDRESS: CITY: STATE: ZIP:
WILLIAMS BRADLEY G 14621 MARSHVIEW DR JACKSONVILLE FL 32250
BEACH
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.
7
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
-f=jz
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
AC AND REFRIGERATION 455-0000-322-1000 5.5 $40.00
FURNACES AND HEATING 455-0000-322-1000 66000 $28.00,
MECHANICAL BASE FEE 455-0000-322-1000 0 $S5.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 J $2.00
issued Date: 7/30/2019 1 of 2
PERMIT NUMBER
MECHANICAL RESIDENTIAL HVAC
CRS19-0258
A
PERMIT
ISSUED: 7/30/2019
CITY OF AT LANTIC BEACH EXPIRES: 1/26/2020
STATE DCA SURCHARGE 45S-0000-208-0600 o $2.00
TOTAL: $127.00
Issued Date:7/30/2019 2 of 2
Mechanical Permit Application "ALL INFORMATION
HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 f\ Q-R S 19
Phone: (904) 247-5826 Email: PERMIT#:
JOB ADDRESS: PROJECTVALUE $
:D-', `NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI#(REQw�)
El Air Handling Equipment Only 0 Condenser Only Ej Air Handling Unit& Condenser
Air Conditioning: Unit Quantity Tons per Unit -Z (,-/-3 '.'
Heat: Unit Quantity -7— BTUs per Unit Seer Rating (REQUIRED)
Duct Systems: Total CFM 1,1,-U -- i
REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI#(REQUIRED)
El Air Handling Equipment Only 0 Condenser Only C]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
7FIRE 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)
7FIRE PLACES 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 BTU s
# Water Heaters Solar Collection Systems
Tanks (gallons)
Wells
f7OTHER:
Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months. I ere y
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 dolate the provisions of any other state or
local law regul-:tion construction or the perfoi mance(,.f..onstruction.
Owner Name:
1. BEcJ-(O$�ne
\A jj an
Mechanical Company: Office Phon,?: oll Fax 09 - I
Co. Address: 3y 1-L C-) --.0 e- C-6 Aq City: State--I� Zi 1): 3 0
License Holder: IU Y)PUYVA Aa mn, State Certificatior,/Registration#
.I tavd
Notarized Signature of License Holder I 'd
joing instrument was acknowledged before me this day of 30 20 1 1 in the State of Florida,
The fore
County of_ 1?,j\j tY� Signature of Notary Publi
e-v.p
z� NAKY JANE DEmPSEY
CWrA4WM#GG 301072
&06o F"ary 112.2023 M"Personally Known OR produced Identifi,ation
Type of Identification:
Updated 1019118
Cash Register Receipt Receipt Number
City of Atlantic Beach R9732
DESCRIPTION ACCOUNT CITY PAID
PermitTRAK $1'27.00
ACRS19-0258 Address: 322 4TH ST APN: 169815 0150 $127.00
MECHANICAL $123.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
AC AND REFRIGERATION 455-0000-322-1000 6 $40.00
FURNACES AND HEATING 455-0000-322-1000 66000 $28.00
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: R9732 $127.00
Date Paid: Tuesday,July 30, 2019
Paid By: HAMMOND AIR CONDITIONING INC
Cashier: CB
Pay Method: CREDIT CARD 11
Printed:Tuesday,July 30, 2019 3:40 PIVI 1 of 1