1912 Oak Circle GSRS19-0070 Water Heater - MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
PERMIT GSRS19-0070
ISSUED: 8/26/2019
CITY OF ATLANTIC BEACH EXPIRES: 2/22/2020
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL • ' K MUST CONFORM TO THE CURRENT 6TH EDITION1 OF • ' + BUILDING
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL • 1 OF PERMIT APPLY, PLEASE READCAREFULLY.
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.
• : ADDRESS: • VALUE OF • •
1912 OAK CIR MECHANICAL RESIDENTIAL GAS GAS PIPING - WATER
HEATER $500.00
TYPE OF
ZONING: :D •
CONSTRUCTION: NUMBER: GROUP:
172020 1254 SELVA MARINA UNIT
12A
COMPANY: DD
FLORIDA PROPANE-Griffis 461 TRESCA RD JACKSONVILLE FL 32225
Gas
• ADDRESS:
COOK THOMAS J 1912 OAK CIR ATLANTIC BEACH FL 32233-4506
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.
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
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
VENTED WALL FURNACE WATER HEATER UNIT 45S-0000-322-1000 1 $5.00
Issued Date:8/26/2019 1 of 2
MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
PERMIT
GSRS19-0070
ISSUED: 8/26/2019
CITY OF ATLANTIC BEACH EXPIRES: 2/22/2020
TOTAL: $64.00'
Issued Date: 8/26/2019 2 of 2
MECHANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904) 247-5826 Fax (904) 247-5845 C-, S RS (c -0(-)'7
.TOB ADDRESS: � 9 1'' - �c\� C�, PERMIT# 1
PROJECT VALUE $ c>O ARI# REQUIRED
Air Handling Equipment Only Air Handling Unit & Condenser Condenser Only
NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity Tons Per Unit
Heat: Unit Quantity BTU's Per Unit Seer Rating
Duct Systems: Total CFM REQUIRED
REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity Tons Per Unit
Heat: Unit Quantity BTU's Per Unit Seer Rating
Duct Systems: Total CFM REQUIRED
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 BTU's
Elevators/Escalators
ALL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets Pumps
#Vented Wall Furnaces Refrigerator Condenser BTU's
# Water Heaters _j_ 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.
Property Owners Name o 1 Phone Number V a3j S1 I
Mechanical Company or,d �� ane c("r �� F .s (Tc Office Phone ,Fax 0Y U( Y�
Co. Address: ` fe City State Zip Z Z`
License Holder(Print): x State fic do e ist tion#_ 3 Z
Notarized Signature of License Ider
� Y'dy•. TON{GINDLESPERGER
MY COMMISSION#FF 924951 efore me this day o 20
EXPIRES:October 6,2019
$ 4 e°P' Bonded Thru Notary Public Undernr ters ignature of Notary Public
d
J3
Cash Register
■ ■ • Receipt
City of ■ • • I •
DESCRIPTION
PermitTRAK $64.00
GSRS19-0070 Address: 1912 OAK CIR APN: 172020 1254 $64.00
MECHANICAL $60.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
VENTED WALL FURNACE WATER HEATER 455-0000-322-1000 1 $5.00
UNIT _r
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: R9946 $64.00
Date Paid: Monday, August 26, 2019
Paid By: FLORIDA PROPANE-Griffis Gas
Cashier: CB
Pay Method: CREDIT CARD 8
Printed: Monday,August 26,2019 2:21 PM 1 of 1