377 12th St ACRS19-0289 Replacement •S%'t`''''% MECHANICAL RESIDENTIAL HVAC PERMIT NUMBER
V.
s� ACRS19-0289
PERMIT ISSUED: 8/22/2019
CITY OF ATLANTIC BEACH EXPIRES: 2/18/2020
MUST CALL INSPECTION • i . + + PM FORDAY • i
ALL • ' CONFORM i THE CURRENT 6TH EDITION1 OF • ' ! + BUILDING
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL • ! • OF APPLY, PLEASE + ! 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: PERMITTYPE: DESCRIPTION: VALUE OF WOR
MECHANICAL RESIDENTIAL replace 2.5-ton 28.8K-BTU
377 12TH ST H $7135.00
VAC AHU
TYPE OF . BUILDING
ZONING: :D •
• • GROUP:
171920 0000 SELVA MARINA UNIT 01
COMPANY: ADDRESS:
ENVIRONMENTAL AIR 8110 CYPRESS PLAZA DR STE 106 JACKSONVILLE FL 32256
SERVICES,INC
• ADDRESS:
WILLIAM T TOMSON AND
ANNE B TOMSON 377 12th St Atlantic Beach FL 32233
REVOCABLE TRUST
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.
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
AC AND REFRIGERATION 455-0000-322-1000 2.5 $16.00
FURNACES AND HEATING 455-0000-322-1000 28800 $24.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
Issued Date:8/22/2019 1 of 2
Mechanical Permit Application "ALL INFORMATION
�. HIGHLIGHTED IN
J r '" City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: CSI 1 -aT 7
JOB ADDRESS: 377 12th Street,Atlantic Beach,Ft_32233 PROJECT VALUE $7,135.00
❑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) 10093527
❑ Air Handling Equipment Only ❑ Condenser Only p Air Handling Unit& Condenser
Air Conditioning: Unit Quantity 1 Tons per Unit 2.5
Heat: Unit Quantity 1 BTU's Per Unit 28800 Seer Rating (REQUIRED) 17.00
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 Pumps
#Vented Wall Furnaces Refrigerator Condenser BTUs
#Water Heaters Solar Collection Systems
Tanks (gallons)
Wells
[--]OTHER:
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:Bill&Anne Tomson Phone Number: 1904)8-6985
Mechanical Company: Dominion Air,dba EAG Services Office Phone: (9D4)279-0030 Fax(904)279-0078
Co. Address: 8110 cypress Plaza Drive,Ste 106 City: Jacksonville State: FL Zip: 32256
License Holder: Howard K. Stalls,Jr. State Certification/Registration # CAC057409
Notarized Signature of License Holder
The foregopZ Instrur�ent was acknowledged before me thi .day of , 20� in the State of Florida,
County ofo`\
Signature of Notary
^y ,; KAYVEGA•NAVARRO Personally Known OR [ ] Produced Identification
Caondaslon#GG238930 pe of Identification:
ro`.=Expires July 17,
2022
Nrded TW Tmy FA Wwlnp 8pp4W701 Updated 10/9/18