211 Beach Ave ACRS19-0353 MECHANICAL RESIDENTIAL HVAC PERMIT NUMBER
ACRS19-0353
PERMIT
ISSUED: 10/23/2019
CITY OF ATLANTIC BEACH EXPIRES: 4/20/2020
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:
211 BEACH AVE MECHANICAL RESIDENTIAL HVAC- 1 A/C, 1 AHU, 2.5 $4863.00
HVAC TON
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
170188 0000 ATLANTIC BEACH
COMPANY: ADDRESS: CITY: STATE: ZIP:
DONOVAN HEATING &AIR JACKSONVILLE
315 6TH AVENUE SOUTH FL 32250
CONDITIONING BEACH
OWNER: ADDRESS: CITY: STATE: ZIP:
SIMMONS RICHARD L 211 BEACH AVE ATLANTIC BEACH FL 32233-5214
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.
FEES
easula
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
AC AND REFRIGERATION 455-0000-322-1000 2.5 $16.00
FURNACES AND HEATING 455-0000-322-1000 28200 $24.00
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
Issued Date: 10/23/2019 1 of 2
91% ,. MECHANICAL RESIDENTIAL HVAC PERMIT NUMBER
PERMIT ACRS19-0353
'c ' ' ISSUED: 10/23/2019
� ,Iteiiiii CITY OF ATLANTIC BEACH EXPIRES: 4/20/2020
TOTAL: $99.00
Issued Date: 10/23/2019 2 of 2
Mechanical Permit Application 'ALL INFORMATION
- ,, Application HIGHLIGHTED 1N
lr , i< City of Atlantic Beach Building Department GRAY IS REQUIRED.
f;\ 800 Seminole Rd, Atlantic Beach, FL 32233 �� CI R5 i 9 -0353
'' Phone: 1904) 247-5826 Email: Building-Dept@coab.us PERMIT R:
JOB ADDRESS: 21' BEACH AVE PROJECT VALUE $4.43-00
❑NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARi #(REQUIRED)
❑Air Handing Cgt,iprrent Only ❑ Cori.der;ser Orgy 0 kr Handling L,nrt & Condenser
Air Conditioning Unit Quantity I ons per Unit
Heat: Unit Quantity_._ BTUs per Unit _ _ Seer Rating(REQUIRED)
Duct Systems Total CFM _
REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION AR1#(REQUIRED) 7'3399922?
❑Air Handling Fquipment Only Cl Condenser Only 0 Air Handling Unit& Condenser
Air Conditioning: Unit Quantity 1 Tons per Unit 5
Heat: Unit Quantity 1 BTU's Per Unit 2A•220 Seer Rating fRFQtlitrED) 'S•°
Duct Systems; Total CI-M
❑FIRE PREVENTION
lire Sprinkler System Quantity IRequjres 3 slits of plans)
Fire Standpipe Quantity (Requires 3 sets of plans)
Underground Fire Main Value (Requires 3 sets of plans)
Fire Hose Cabinets Quantity (Recuires 3 sets of plans)
Commercial Hoods Quantity (Requires 3 sel s of plans)
Fre Stipp7essian Systems Quantity (Ret7•,ires 3 sets of plans)
FIRE PLACES E MISCELLANEOUS:
Prefabricated Fireplace {Qty) Automobile lifts
Gas Piping Outlets Boilers BTUs
E eyators/Escalators
MALL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets Pumps
If Vented Wa>I Furnaces Refrigerator Condenser BTUs—
I: Water heaters Solar Collection Systems
-ankslgallons)
Wells
OTHER:
Permit becomes void if wort dne%not commence within a six monto period or work s suspended or abandoned for six months. I hereby
certify that I have read this map':cation and knov,the same to be true and correct. All provisions of Taws and ordinances governing this
work will be rn•-iplled with whether specified or riot. the permit does not give authortyto violate the pravisla•es of any other state or
I!:c.a law reg.laticcn corstrue:ticm or the performance of cc:nstruction.
Owner Name:RICHARD SIMMONS Phore NJrrber: {904}626-6823
fvlecha n cal Ca mpary: DeilvD 'Atw 1---EAT&AIR Office Phone; .:97.1:241:41E6 Far•'0I i 241-3745
Co. Address: sty err,atm ti City': JP.%BEACH State: FL Zip. 32280
License Holder: WILLIAM DONOVAN State Cert I :,+1 eri:Rriist•ation Ot
Notarized Signature of License Holder 4:4Kftr– 4 r-om..:
-, e for eV Ili?,i nrV i.m=nt leas ackn r..v iedge0 before me this 23 day of n ,P :20 Sc'1,in the State of Florida,
t.:,1.1 r'i c!' Shat'''
Signature of Notary Public R:Aczt+�,� L.,
7m.....unn.r.16,16. --- --
�V.':!.V fLCHARD LTA Personally Known OR [ ) Produced Identification
! 5115
; • • .. , Type of Identification: , __
:- 1i} ` =Ipri�eJW'.3.r2inrnissar!GI3 1191 , uvabtriti!t+1i78
•;,';'1. itrdeli rsen Fal M
Trill oracetOMI,rill
!a'r,J
.� •_ Cash Register Receipt Receipt Number
!�v r
City of Atlantic Beach R10817
•.ori 9/
DESCRIPTION I ACCOUNT I QTY I PAID
PermitTRAK $190.00
ACRS19-0353 Address: 211 BEACH AVE APN: 170188 0000 $99.00
MECHANICAL $95.00
1 MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
I
AC AND REFRIGERATION 455-0000-322-1000 3 $16.00
FURNACES AND HEATING 455-0000-322-1000 28200 $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
ACRS19-0354 Address: 1820 SEVILLA BLVD 310 APN: 169399 0666 $91.00
MECHANICAL $87.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
AC AND REFRIGERATION 455-0000-322-1000 2 $8.00
FURNACES AND HEATING 455-0000-322-1000 18000 $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: R10817 $190.00
Date Paid: Wednesday, October 23, 2019
Paid By: DONOVAN HEATING &AIR CONDITIONING
Cashier: CT
Pay Method: CREDIT CARD 7
Printed:Wednesday,October 23, 2019 1:26 PM 1 of 1 IF