1804 Selva Grande Dr MCRS19-0007 Duct Work Only MECHANICAL RESIDENTIAL OTHER PERMIT NUMBER
MCRS19-0007
PERMIT
ISSUED: 9/23/2019
CITY OF ATLANTIC BEACH EXPIRES: 3/21/2020
MUST CALL INSPECTION PHONE LINE (904) 247-5814 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 . D 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:
1804 SELVA GRANDE DR MECHANICAL RESIDENTIAL HVAC - DUCT WORK ONLY $2649.00
OTHER
TYPE OF
• • GROUP:
169542 5002 SELVA TIERRA
COMPANY: ADDRESS:
OCEAN STATE HEAT& AIR, 1476 ATLANTIC BLVD NEPTUNE BEACH FL 32266
INC.
• ADDRESS:
EAKIN LAURA MCDONELL 1804 SELVA GRANDE DR ATLANTIC BEACH FL 32233-4526
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 • .
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
AIR DUCT SYSTEM 455-0000-322-1000 800 $20.00
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
TOTAL: $79.00
Issued Date: 9/23/2019 1 of 2
MECHANICAL RESIDENTIAL OTHER PERMIT NUMBER
PERMIT MCRS19-0007
ISSUED: 9/23/2019
CITY OF ATLANTIC BEACH EXPIRES: 3/21/2020
Issued Date:9/23/2019 2 of 2
Mechanical Permit Application
City of Atlantic Beach Building Department
800 Seminole Rd, Atlantic Beach, FL 32233 C WS 9 C-)CD-7
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMff r:
JOB ADDRESS:
;.S.Z` SRA VQ— liPROJECT VALUE$' R(nq r T
❑NEW AiR CONDITIONING&HEATING SYSTEM INSTALLATION ARI#(REQUIRED)
O 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 G 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
[]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 Solaf Collection Systems
Tanks (gallons)
1 �'\, Wells l -
THER: ` -'� `-vit Ute !IL a "ttJY1
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 compiled 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.
41
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Owner NamePhone Number:
Mechanical Company:��r-1 Office Phone: nN-oA I , Fax tom
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Co.Address: IL (2AC--
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Ucense Holder: �• C nrN a e Ion/Registration# �
Notarized Signature of Lkense Holder
The foregoinnstru ent was a 4ledg is day of 20A in a State of Florida,
yffmp.molthl s ture of otary Public
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• ca #GGOW02 1-�Personally Known OR I ] Prb uced identification
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Type of Identification:
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