320 10th St GSRS19-0077 Gas Line „,,, v;,, MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
o
���i.'” PERMIT GSRS19-0077
�rz.
ISSUED: 10/10/2019
CITY OF ATLANTIC BEACH EXPIRES:
4/7/2020 J
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 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.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
run interior gas line for 5
320 10TH ST MECHANICAL RESIDENTIAL GAS $3321.41
gas piping outlets
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
170032 0000 ATLANTIC BEACH
COMPANY: ADDRESS: CITY: STATE: ZIP:
OWNER: ADDRESS: CITY: STATE: ZIP:
BRECHBILL ALAN L 479 ENGLISH IVY CT HUMMELSTOWN PA 17036
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
Roll 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 5 $12.00
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:$71.00
Issued Date 10/10/2019 1 of 1
MECHANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph (904) 247-5826 Fax (904) 247-5845 S2S
OB ADDRESS:. g)- /OA Si✓ /4414 pi he Ra A� & 322 .3 PERMIT#1 t. - -
Pel OJECT VALUE S 3, S 0 ''t1 _ .-IRI# REQUIRED
Air Handling Equipment Only Air Handling Unit & Condenser Condenser Onll,
NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air conditioning: Unit Quantity Tons Per Unit
Heat: Unit Quantity BTU's Per Unit Seer Rating
Dugt Systems: Total CFM REQUIRED
i
R EPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION
. i- Conditioning: Unit Quantity Tons Per Unit
Heat: Unit Quantity BTU's Per Unit Seer Rating
'nuc' Systems: Total CFM vREOUIRED
FIRE PREVENTION
'= :-c Sprinkler System Quantity (Requires 3 sets of plans)
re;Standpipe Quantity (Requires 3 sets of plans)
'_ ni.erground Fire Main Value (Requires 3 sets of plans)
Hose Cabinets Quantity _ (Requires 3 sets of plans)
-----'ercial Hoods Quantity (Requires 3 sets of plans)
:_ippression rSystems Quantity (Requires 3 sets of plans)
IRE PLACES MISCELLANEOUS:
Prefabricated Fireplace Qty Automobile Lifts
Gas Piping Outlets Boilers BTU's
E leyatorsEscalators
A.LI. OTHER GAS PIPING Heat Exchanger
Quantitt of Outlets Pumps
= Vnted Wall Furnaces Refrigerator Condenser BTU's
_: Water Heaters Solar-Collection Systems
Tanks (gallons)
A-
Wells
OTHER: ton r ti.rpf"" otic- 6fie A-( fit 4ev Af4 ier5 i0)rQtee_ ,10��-,i/ 4/1(1
ito,
b.::omes%aid i work does not commence within a six month period or work is suspended or abandoned for six months.I hereb} ceniff that!:ha\: r:.;.
-`.:cyton and know the same to be true and correct. Ali provisions of taws and ordinances governing this work will be complied with whether spc:i•':.;
. . .. .^does not give authority to violate the provisions of any other state or local law regulation construction or the performan^e of co•-: truc::c:
P70 : ::-ty Ovyners Name // /5re'G ,jl Ii Phone Numb�r,�+�. i - Ci.
MN/.,1, (��/)
.,_%IIedlicai Cuinpan: l'1.1 45. '1U, 112i'f Office Phone�2i 3/ Fax"V I-.5'7,37 ..
,. :Ad:.i'ess: lit 9 40-e, fine City Jacksoot4fie State FL Zip 322//-_
.-_`.;• nsetHolder(Print): A.L/1A/1 L Laiti State Certification/Registration# ���
'�r�Ffrr•i.,•., .5iarratrri•e of License Holder
0,t
,./4
Before me this fVtii day of_Ctpker_ 20 f q
•
,,. •\ Notary Public State of Florida
Stephanie Renee McGuire Signature of Notary Public frn
c A. My Commission GG 123258 — `
w
Expires 08/01/202i