1855 Beach Ave ACRS19-0355 MECHANICAL RESIDENTIAL HVAC PERMIT NUMBER
PERMIT ACRS19-0355
ISSUED: 10/25/2019
CITY OF ATLANTIC BEACH EXPIRES:4/22/2020
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:
1855 BEACH AVE MECHANICAL RESIDENTIAL HVAC - 1 A/C, 1 AHU, 2.5 $5500.00
HVAC TON
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
169723 1115 THE NAUTILUS
CONDOMINIUM
COMPANY: ADDRESS: CITY: STATE: ZIP:
DONOVAN HEATING & AIR JACKSONVILLE
315 6TH AVENUE SOUTH FL 32250
CONDITIONING BEACH
OWNER: ADDRESS: CITY: STATE: ZIP:
MATHEWS DONNA 3292 FM 1699 AVERY TX 75554
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 28200 $24.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
Issued Date: 10/25/2019 1 of 2
%S,-tikreMECHANICAL RESIDENTIAL HVAC PERMIT NUMBER
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.r; PERMIT ACRS19-0355
,\,,v, ISSUED: 10/25/2019
.; �;;�, V CITY OF ATLANTIC BEACH EXPIRES: 4/22/2020
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $99.001
Issued Date: 10/25/2019 2 of 2
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t- Mechanical Permit Application "AU INFORMATION
HIGHLIGHTED IN
1
City of Atlantic Beach Building Department GRAY IS REQUIRED.
'. ROO Seminole Rd, Atlant c Beach, FL 32233 ��CRS i 9 - 03 SS
'— Phone: (904) 247-5826 Email: Ruilding-Depty coab.us PERMIT M:
JOB ADDRESS: 1855 BEACH AVE PROJECT VALUE $5,500.00
Ej NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION AR!#(REQUIRED)
❑Air Handling Equipment Only Q Condenser Only ❑Al' HonciJ ng Unit& Condenser
Air Conditioning: Unit Quantity Tons per Unit
Heat: Unit Quantity BTUs per Unit Seer Rating(REQUIRED)
Duct Systems: Total CFM
D✓ REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI tl (REQUIRED) iny-+in2
❑Air Hondling Equipment Only ❑ Condenser Only 0;: ' ;-ro.nd/inq Unit&Condenser
Air Conditioning: Unit Quantity ' Tois per Unit 2-5
Heat: Unit Quantity I BTU's Per Unit 76200 S_._•r R•ti•ie; /REQUIRED) 15.00
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 []MISCELLANEOUS:
Prefabricated Fireplace(Qtyl Automobile Lifts
Gas Piping Outlets Boilers BTUs
Elevators/Escalators
CALL OTHER GAS PIPING Heat Exchanger
QJantity of Outlets Pumps
N Vented Wall .Furnaces Refrigerator Condenser BTUs
4 Water Heaters Solar Collection Systems
Tanks(gallons)
Wells
OTHER:
Prrmi bccc-nes vim if work dues not commence Zvi:^rn 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 hr true and correct. All provisions of laws and ordinances governing this
work MI'be complied with whethe•specified or not. 'hr permit does no_pre authority to violate the provisions of any other state ur
local law regulation construct o,or the perform:lair of mnst•uction.
Owner Name:DONNA MATHEWS Phone NJrnber: (904)33R-7319
Mechanical Corn pany: DONOVAN HEAT&AIR Office Phone: (SO■ti 2414785 Faxi90.1)241-:e745
Co.Address:215 FM AVE S City JAx BEACH State Fl 2 p; 32250
License Holder WILLIAM DONOVAN _ '/ State Certification/Registration 4 CA03397
Notarized Signoture of License Holder
•
The foregoing instrument was acknowledged before me this 2' ' day o ..OG7b _, 20 lq ,in the State of Florida,
Coll myof j'x,NAL-
Signature of Notary Public4r+,�,
.r►
},n, Richmt►LTiOLIPIO4S 4 Personally Known OR [ j PrudJ•_i.J ljentisicatior
• CotnneIsbn#GC 111S
��' •j F Pis dv.75,2C21
'ype of Identification:
�`.„S,>,Y :orae Tfry FvrFib 4wagi -
p1,1K7�q UOd'ftrd:reli r"1.4
,S�K . m •f
r Cash Register Receipt Receipt Number
City of Atlantic Beach R10847
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $99.00
ACRS19-0355 Address: 1855 BEACH AVE APN: 169723 1115 $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 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
TOTAL FEES PAID BY RECEIPT: R10847 $99.00
Date Paid: Friday, October 25, 2019
Paid By: DONOVAN HEATING & AIR CONDITIONING
Cashier: CB
Pay Method: CREDIT CARD 2
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Printed: Friday,October 25, 2019 8:17 AM 1 of 1 t