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1249 Beach Ave GSRS19-0085 Piping :S i:.\:, � MECHANICAL RESIDENTIAL GAS PERMIT NUMBER J )� i\ � _._ �, PERMIT GSRS19-0085 �y � ISSUED: 10/22/2019 "%, , CITY OF ATLANTIC BEACH EXPIRES: 4/19/2020 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: t VALUE OF WORK: 1249 BEACH AVE MECHANICAL RESIDENTIAL GAS install 500 gal. tank & gas $1503.50 piping outlet TYPE OF REAL ESTATE 1 ZONING: BUILDING USE SUBDIVISION: CONSTRUCTION: NUMBER: GROUP: 170292 0000 ATLANTIC BEACH COMPANY: ADDRESS: CITY: STATE: ZIP: OWNER: ADDRESS: CITY: STATE: ZIP: BOENEKE DEMORY 7093 OX BOW RD TALLAHASSEE FL 32312 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 GAS PIPING OUTLETS 455-0000-322-1000 1 $10.00 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 TANKS GAS OR LIQUEFIED PETROLEUM 455-0000-322-1000 500 $20.00 TOTAL: $89.00 Issued Date: 10/22/2019 1 of 2 j � "'�'% MECHANICAL RESIDENTIAL GAS PERMIT NUMBER s` PERMIT GSRS19-0085 �r1 ISSUED: 10/22/2019 �,� , CITY OF ATLANTIC BEACH EXPIRES:4/19/2020 Issued Date: 10/22/2019 2 of 2 * -ss%' TION hevrMechanical Permit Application IGSMA �, ,,��GHTED IN f ..4*-41*„.a. City of Atlantic Beach Building Department r. , „ t �rISREQUIRED. 800 Seminole Rd, Atlantic Beach, FL 32233 `r'a'' ' Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: c SQ-SVl- D(Dg- JOB ADDRESS: ( a LI c a" , bj/e .. / PROJECT VALUE$ '30-'3 ❑NEW AIR CONDITIONING &HEATING SYSTEM INSTALLATION AR!#(REQUIRED) 0 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 0 REPLACEMENT AIR CONDITIONING& HEATING SYSTEM INSTALLATION ARI#(REQUIRED) 0 Air Handling Equipment Only ❑ Condenser Only ©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) 0FIRE 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) o o cJc.L) Wells OTHER: (1A'C✓l b r It V-) ,-- — TC r v1--,t-(-- r\ k- --I-- (A i f-,-, e_,Y-}C,?o 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: "L) .Yl o-r 1�► tt_ `,- z.iit:. „ ^` WOW,-Phone Number: GY- VSA Mechanical �� "Company: - , , fir~~ < ,t.z : " Office Phone: ', �( .:t' Fax 72/ -S`�3/ Co.Address: •. - A i'- sice'"'I .--:,14. ;s City: '. k* �' .} -State:FL—Zip: 3 2-7---t License Holder: Ir a c r;s State Certification/Registration# �3 4 Notarized Signature of License#1,4 er te L;,..c. J + w °:" - •.; ,., The foregoi r: instrum-nt was acknowledged before me this ,tS .• of 6C Fes+ ,20 4�in th State of Florida, • ,. • ' Signature of Notary Pub tcz b. . 14 1 l`, ' �' wNotary Public State of Honda Stephanie E Carter 1/44,,.d' My Commission GG 238425 [ Personally Known OR[ 1 Produced Identification Expires 07/18/2022 Type of Identification: Updated 10/9/18 •i `lr r �S Cash Register Receipt Receipt Number ' r :z.- City of Atlantic Beach R10801 DESCRIPTION I ACCOUNT QTY I PAID PermitTRAK $178.00 GSRS19-0084 Address: 513 N NAUTICAL BLVD APN: 170703 0296 $89.00 MECHANICAL $85.00 MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00 GAS PIPING OUTLETS 455-0000-322-1000 2 $10.00 TANKS GAS OR LIQUEFIED PETROLEUM 455-0000-322-1000 120 $20.00 STATE SURCHARGES $4.00 STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00 I STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00 GSRS19-0085 Address: 1249 BEACH AVE APN: 170292 0000 $89.00 MECHANICAL $85.00 MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00 GAS PIPING OUTLETS 455-0000-322-1000 1 $10.00 TANKS GAS OR LIQUEFIED PETROLEUM 455-0000-322-1000 500 $20.00 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: R10801 $178.00 Date Paid: Tuesday, October 22, 2019 Paid By: D & D Gas, Inc. Cashier: CT Pay Method: CREDIT CARD 2 Printed:Tuesday,October 22, 2019 2:07 PM 1 of 1 Il