801 Paradise Ln GSRS19-0069 MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
PERMIT GSRS19-0069
ISSUED: 8/13/2019
},; CITY OF ATLANTIC BEACH EXPIRES: 2/9/2020
MUST CALL INSPECTION • • • 1 PM FOR + INSPECTION.
ALL • 'K MUST CONFORM TO THE CURRENT 6TH EDITION1 OF • '
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.
■ is DD • OF • •
801 PARADISE LN MECHANICAL RESIDENTIAL GAS GAS PIPING - 3 OUTLETS $1650.00
AND 120 GAL TANK
TYPE OF
• • GROUP:
172376 0165 PARADISE PRESERVE
COMPANY: ADDRESS: CITY: STATE: ZIP:
D & D Gas, Inc. 7709 Alton Ave Jacksonville FL 32211
• ADDRESS:
SPRINGFIELD BUILDERS LLC 1881 BEACH AVE 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 CONDITIONS
(IRoll 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 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
TANKS GAS OR LIQUEFIED PETROLEUM 455-0000-322-1000 120 $20.00
VENTED WALL FURNACE WATER HEATER UNIT 455-0000-322-1000 1 $5.00
Issued Date: 8/13/2019 1 of 2
MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
GSRS19-0069
PERMIT
ISSUED: 8/13/2019
CITY OF ATLANTIC BEACH EXPIRES: 2/9/2020
TOTAL: $94.00''
Issued Date:8/13/2019 2 of 2
Mechanical Permit Application " **ALL{NF INFORMATION
MM � °; HIGHLIGHTED IN
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City of Atlantic Beach Building Department �r GRAY15i>IE. UIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 _�O q
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:
108 ADDRESS: 0-301 - : �...:' -� �fA° `Y= PROJECT VALUE$ •/(n'�Z7. Uri
❑NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI#(REQUIRED)
11 Air Handling Equipment Only 0 Condenser Only 0 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 E3 Condenser Only p 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 r7 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) /a O
Wells
F-JOTHER: o. ie-41- CE ri�/ S7L�d• k- .�
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:�7i^I✓tY1c= i el e? t` #`r �t3-_: ;:; . Y ` r. Phone Number: Dy—{off
Mechanical Company: �:'��j..x1
Office Phone: !l-'�V� Fax S"3 y6
Co.Address: City k� ti'State: zip: 3 LZ-11
License Holder: A A,% CAaJA State Certification/Registration#R410 old 9
Notarized Signature of License er G2 ra 1.y /�r ( .rl r — r � ;t, ,,A?i • ' ��
The foregoi g instrument was acknowledged before me this /,: '%y of J t 20 �9 inn e
theState of Florida,
Signature of Notary Pubic i�
�•�r Notary Puolie State of Florida
�-
Stephan a ECarter
rl� My Commission GG 299425 [personally Known OR [ ] Produced Identification
y
d Expi
res 07118/2022
Type of Identification:
fJpdoted 10/9/18
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Cash
r Register
0-01
City ofAtlanticBeach R9837
DESCRIPTION • CITY PAID
PermitTRAK $94.00
GSRS19-0069 Address: 801 PARADISE LN APN: 172376 0165 $94.00
MECHANICAL $90.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
GAS PIPING OUTLETS 455-0000-322-1000 2 $10.00
TANKS GAS OR LIQUEFIED PETROLEUM 455-0000-322-1000 120 $20.00
VENTED WALL FURNACE WATER HEATER 455-0000-322-1000 1 $5.00
UNIT
STATE SURCHARGES $4.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
ITOTAL FEES PAID BY RECEIPT: R9837 $94.00
Date Paid:Tuesday, August 13, 2019
Paid By: D& D Gas, Inc.
Cashier: CT
Pay Method: CREDIT CARD 01348C
Printed:Tuesday,August 13,2019 4:14 PM 1 of 1