175 Jackson Rd ACRS19-0274 MECHANICAL RESIDENTIAL HVAC PERMIT NUMBER
ACRS19-0274
PERMIT
ISSUED: 8/15/2019
` ,�,;�,; CITY OF ATLANTIC BEACH EXPIRES: 2/11/2020
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORMTO THE CURRENT 6TH EDITION1 OF • ' DA BUILDING
CODE, ' AND OF • OF ORDINANCES .
ALL • • OF PERMITr r PLEASE
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.
I
• : PERMIT TYPE: • • OF •
175 JACKSON RD MECHANICAL RESIDENTIAL HVAC - 1 A/C, 1 AHU, 2.5 $3327.00
HVAC TON
TYPE OF
• • GROUP:
172129 0200 DONNERS S/D PT LOT 2
ADDRESS: CITY: STATE: ZIP:
Elite AC, LLC 6060 Chester Circle JACKSONVILLE FL 32217
ADDRESS: CITY: STATE: ZIP:
D & L ENTERPRISES LLC 13925 HUNTERWOOD RD JACKSONVILLE FL 32225-1905
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 . .
iRoll off container company must be on City approved list . Container cannot be placed on City right-of-way.
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
AC AND REFRIGERATION 455-0000-322-1000 2.5 $16.00
FURNACES AND HEATING 455-0000-322-1000 28400 $24.00
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
Issued Date: 8/15/2019 1 of 2
�1!:1P'rlJ MECHANICAL RESIDENTIAL HVAC PERMIT NUMBER
r S � ACRS19-0274
PERMIT ISSUED: 8/15/2019
CITY OF ATLANTIC BEACH
EXPIRES: 2/11/2020
TOTAL:$99.00
Issued Date: 8/15/2019 2 of 2
Mechanical Permit Application "AUwoRsmnoN
PP HIGHLIGHTED IN
City of Atlantic Beach Building Department 6RAY6RECKU D.
800 Seminole Rd,Atlantic Beach, FL 32233 { �'_( v 1
� ` I "y z-74
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT B:
JOB ADDRESS: 175 Jardgwo Road.-AtionticBeactt,FL 32233 PROJECT VALUE$3,327
NEW AIR CONDITIONING&HEATING SYSTEM INSTALLATION ARI#(REQUIRED)
D Air Handling Equipment Only 0 Condenser Only [3 Air Handling Unit& Condenser
Air Conditioning: Unit Quantity Tons per Unit
Heat: Unit Quantity BTUs per Unit Seer Rating(REQUIRED)
Duct Systems: Total CFM
l7 REPLACEMENT AIR CONDITIONING&HEATING SYSTEM INSTALLATION ARl#(REQUIRED) 7985112
❑Air Handling Equipment Only D Condenser Only D Air Handling Unit& Condenser
Air Conditioning: Unit Quantity 1 Tons per Unit 2.5
Heat: Unit Quantity 1 BTU's Per Unit 28.400 Seer Rating(REQUIRED) 14
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
MALL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets Pumps
#Vented Wall Furnaces Refrigerator Condenser BTUs
#Water Heaters Solar Collection Systems
Tanks(gallons)
Wells
F-JOTHER' HVAC Change Out:Goodman 2.5 ton 14 seer GSZ140301 ARUF29814
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: Re9ira Lyles —' L f (�1 l=c'-� Phone Number 904610.24W
Mechanical Company: QAC LLC Office Phone: 9904--323-4611 fax
Co.Address:6080Ch8swGir�le Cit JsGcaonviae State: Zip:32217
License Holder: RobeA Ormt St ification/Registration#CAC1818659
Notarized Signature of License Holder a 7—
Theforegawgin trument was acknowledged before me this Q day of toff in the State of Florida,
County of
Signature of Notary Publi
JESWAM.00(3IRMd k1fPersonally Known OR [ J Produced Identification
CaarelssbnfC;338D2U Type of Identification:
..
Updated 10/9/18
t
.t`r` 8ondeE Wo"Fab lawara 6W485.7019
J ssl Register
• • • Receipt Number
y
City N
. ti
• : ' R9847
DESCRIPTION • QTY PAID
PermitTRAK $99.00
ACRS19-0274 Address: 175 JACKSON RD APN: 172129 0200 $99.00
MECHANICAL $95.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
AC AND REFRIGERATION 455-0000-322-1000 3 $16.00
FURNACES AND HEATING 455-0000-322-1000 28400 $24.00
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: R9847 $99.00
Date Paid:Thursday, August 15, 2019
Paid By: Elite AC, LLC
Cashier: CT
Pay Method: CREDIT CARD 012309
Printed:Thursday,August 15,2019 9:24 AM 1 of 1
,xiuu,
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Receipt NumberCash Register ReceiptCity of
DESCRIPTION • QTY PAID
PermitTRAK $55.00
ACRS19-0274 Address: 175 JACKSON RD APN: 172129 0200 $55.00
MECHANICAL HVAC FINAL**08/26/2019 DA $55.00
MECHANICAL HVAC FINAL**08/26/2019 455-0000-322-10020 $55.00
DA
TOTAL1 11
Date Paid: Monday, September 09, 2019
Paid By: Elite AC, LLC
Cashier: CB
Pay Method: CREDIT CARD 12
Printed: Monday,September 09,2019 2:11 PM 1 of 1