328 10th St GSRS19-0088 Install Piping MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
\' PERMIT GSRS19-0088
"� ISSUED: 10/22/2019
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-,, ,il/ v CITY OF ATLANTIC BEACH EXPIRES: 4/19/2020
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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:
install gas-piping outlet &
328 10TH ST MECHANICAL RESIDENTIAL GAS $850.00
120 gal. tank for pool heater
TYPE OF REAL ESTATE i BUILDING USE
ZONING: SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
170035 0000 ATLANTIC BEACH
COMPANY: ADDRESS: CITY: STATE: ZIP:
SAWYER GAS OF THE JACKSONVILLE
98 PENMAN RD FL 32250
BEACHES BEACH
OWNER: ADDRESS: I CITY: STATE: ZIP:
DYER KELLY L 328 10TH ST ATLANTIC BEACH FL 32233-5530
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 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 4S5-0000-322-1000 120 $20.00
Issued Date: 10/22/2019 1 of 2
r ''',e, MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
a '� GSRS19-0088
, r, PERMIT
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\ ;un si. ISSUED: 10/22/2019
v CITY OF ATLANTIC BEACH EXPIRES: 4/19/2020
TOTAL:$89.00
Issued Date: 10/22/2019 2 of 2
MECHANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
JP,�h�(904)) 247-5826 Fax(904) 247-5845 c
JOB ADDRESS:. \O C!I 1 'VL-1 PERMIT#6 S V.,(.(- °o
PROJECT VALUE $ R5S),00 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 eli, Boilers BTU's
Elevators/Escalators
ALL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets _i___ Pumps
#Vented Wall Furnaces Refrigerator Condenser BTU's
# Water Heaters Solar Collection Systems
Tanks (gallons) ‘�� aekki.�-n't,
Wells L,
OTHER: Iv\S�f),\ Ck cts *i ' CV p1(J 1 Cor-- p7\ VCtker
3ermit 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
his 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
lot. 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 04\00, \--.)4C Phone Number1(31- (06`^ 1 v1`-ii
Mechanical Company -) J E ()\ --\-KR, ekAr l , , Office Phone a01,O (loQ)Fax737't'f
Co. Address:0g f(r(),C\ a City,e[,sv1g,w,&ack' State—H, Zip 3 22%
•_• • r . •__ - .: ,;: }ACA , i State Certification/Registration# 305`—I4
JENNIFER JOHNSi• /�/�
' ::? i•'�� d Srigrulrt�t�s� lY.'2�e 1.older
"R, iuo' ''' EXPIRES:Octo er 27.2020
;Fo,.,,.oe Bonded Thru Notary Public Underwriters Before me this ?rQ-• day o ,_
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Signature of Notary Public