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1339 Camelia St ACRS19-0350 :,0...wp MECHANICAL RESIDENTIAL HVAC PERMIT NUMBER � a a �;:r_ _, PERMIT ACRS19-0350 1 2 ''i,oliv .;. CITY OF ATLANTIC BEACH ISSUED: 10/16/2019 EXPIRES: 4/13/2020 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 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: 1339 CAMELIA ST MECHANICAL RESIDENTIAL HVAC - 1 A/C, 1 AHU, 2.5 $3000.00 HVAC TON TYPE OF REAL ESTATE 1 ZONING: BUILDING USE SUBDIVISION: CONSTRUCTION: NUMBER: GROUP: 171051 0010 ATLANTIC BEACH SEC H COMPANY: ADDRESS: CITY: STATE: ZIP: Atlantic Coast Heating & Cooling 3599 Lenox Avenue #3 Jacksonville FL 32254 OWNER: ADDRESS: I CITY: STATE: ZIP: ACM CREATIVE PROPERTIES LLC 413 FILMORE DR JACKSONVILLE FL 32225 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 AC AND REFRIGERATION 455-0000-322-1000 2.5 $16.00 FURNACES AND HEATING 455-0000-322-1000 22200 $24.00 MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00 STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00 Issued Date: 10/16/2019 1 of 2 JS 0-As'i-re MECHANICAL RESIDENTIAL HVAC PERMIT NUMBER I r ' PERMIT ACRS19-0350 73 x ISSUED: 10/16/2019 tolti ' CITY OF ATLANTIC BEACH EXPIRES: 4/13/2020 I STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00 TOTAL: $99.00 Issued Date: 10/16/2019 2 of 2 .; Mechanical Permit Application **ALL INFORMATION �� f� HIGHLIGHTED IN — \"' City of Atlantic Beach Building Department GRAY IS REQUIRED. J 800 Seminole Rd, Atlantic Beach, FL 32233 A a(ZS [ 9 03S 0 "'"' � Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: JOB ADDRESS: 1339 Camelia St PROJECT VALUE$3,000.00 ❑NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI#(REQUIRED) ❑Air Handling Equipment Only ❑ 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) 9674447 0 Air Handling Equipment Only 0 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 22,200 Seer Rating(REQUIRED) 14.00 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 n MISCELLANEOUS: Prefabricated Fireplace (Qty) Automobile Lifts Gas Piping Outlets Boilers BTUs Elevators/Escalators fALL 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:ACM CREATIVE PROPERTIES LLC Phone Number: (904)716-5759 Mechanical Company: Atlantic Coast Heating&Cooling Office Phone: (904)343-8934 Fax Co. Address: 3599 Lenox Ave Unit#3 City: Jacksonville State: Fl Zip: 32254 License Holder: Lindsey Spillers ,• State Certification/Registration# CAC1814841 Notarized Signature of License Holder "2,94._.),_ .. The foregoi instrument was acknowledged before me this I (. da of OC7Ob Y ,20 CI, in the State of Florida, County of >. �� \I r' n^ Signature of Notary Public �Xx�L_. 1 Notary Public State of Florida Grandee Marie Post i MyCommissionG t 101850 ['1 Personally Known OR I I Produced Identification 0apd�`' Expires 05/07/2021 Type of Identification: Updated 10/9/18 CERTIFIED www.ahridirectory.org Certificate of Product Ratings AHRI Certified Reference Number:9677356 Date:08-21-2019 Model Status:Active AHRI Type:HRCU-A-CB Series: 14 SEER W SERIES R410A HP Outdoor Unit Brand Name:GRANDAIRE Outdoor Unit Model Number (Condenser or Single Package):WCH4304GKB" Indoor Unit Model Number(Evaporator and/or Air Handler):WAHL304B* The manufacturer of this GRANDAIRE product is responsible for the rating of this system combination. Rated as follows in accordance with the latest edition of ANSI/AHRI 210/240 with Addenda 1 and 2,Performance Rating of Unitary Air-Conditioning&Air-Source Heat Pump Equipment and subject to rating accuracy by AHRI-sponsored,independent,third party testing: Cooling Capacity(A2)-Single or High Stage(95F),btuh:28600 SEER: 14.00 EER(A2)-Single or High Stage(95F):11.50 Heating Capacity(H12)-Single or High Stage(47F):28600 HSPF(Region IV):8.20 t"Active"Model Status are those that an AHRI Certification Program Participant is currently producing AND selling or offering for sale;OR new models that are being marketed but are not yet being produced."Production Stopped"Model Status are those that an AHRI Certification Program Participant is no longer producing BUT is still selling or offering for sale. Ratings that are accompanied by WAS indicate an involuntary re-rate. The new published rating is shown along with the previous(i.e.WAS)rating. DISCLAIMER AHRI does not endorse the product(s)listed on this Certificate and makes no representations,warranties or guarantees as to,and assumes no responsibility for, the product(s)listed on this Certificate.AHRI expressly disclaims all liability for damages of any kind arising out of the use or performance of the product(s),or the unauthorized alteration of data listed on this Certificate.Certified ratings are valid only for models and configurations listed In the directory at www.ahridirectory.org. TERMS AND CONDITIONS This Certificate and its contents are proprietary products of AHRI.This Certificate shall only be used for individual,personal andk, confidential reference purposes.The contents of this Certificate may not,in whole or in part,be reproduced;copied;disseminated; entered into a computer database;or otherwise utilized,In any form or manner or by any means,except for the user's individual, personal and confidential reference. AIR-CONDITIONING,HEATING, CERTIFICATE VERIFICATION &REFRIGERATION INSTITUTE The information for the model cited on this certificate can be verified at www.ahrldlrectory.org,click on"Verify Certificate"link He make lif<•better^ and enter the AHRI Certified Reference Number and the date on which the certificate was Issued, which Is listed above,and the Certificate No.,which is listed at bottom right. ©2019Air-Conditioning, Heating,and Refrigeration Institute CERTIFICATE NO.: 132108811174686622 ij1-U1r/ Cash Register Receipt Receipt Number City of Atlantic Beach zy R10763 - - JHI9 DESCRIPTION I ACCOUNT I QTY I PAID PermitTRAK $99.00 1 ACRS19-0350 Address: 1339 CAMELIA ST APN: 171051 0010 $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 22200 $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: R10763 $99.00 Date Paid: Wednesday, October 16, 2019 Paid By: Atlantic Coast Heating & Cooling Cashier: CT Pay Method: CREDIT CARD 052412 Printed:Wednesday,October 16, 2019 4:40 PM 1 of 1