1945 Brista De Mar Cir ACRS19-0357 rS'�U�r2J' MECHANICAL RESIDENTIAL HVAC PERMIT NUMBER
:- ACRS19-0357
� " PERMIT
ISSUED: 10/25/2019
o,;�;.; 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:
MECHANICAL RESIDENTIAL
1945 BRISTA DE MAR CIR HVAC HVAC - 1 A/C, 1 AHU, 5 TON $8800.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
169506 1660 SELVA NORTE UNIT 02
COMPANY: ADDRESS: CITY: STATE: ZIP:
Elite AC, LLC 6060 Chester Circle JACKSONVILLE FL 32217
OWNER: ADDRESS: CITY: STATE: ZIP:
SIMON KENNETH 1945 BRISTA DE MAR CIR ATLANTIC BEACH FL 322 -
WARNING
223WARNING 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
AC AND REFRIGERATION 455-0000-322-1000 5 $40.00
FURNACES AND HEATING 455-0000-322-1000 56000 $28.00
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
TOTAL: $127.00
Issued Date: 10/25/2019 1 of 2
MECHANICAL RESIDENTIAL HVAC
-51-vi r�� PERMIT NUMBER
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S
s, ACRS19-0357
75� _____! TISSUED: 10/25/2019
�o,; ,� CITY OF ATLANTIC BEACH EXPIRES: 4/22/2020
Issued Date: 10/25/2019 2 of 2
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Mechanical Permit Application -*AU. LIG,RMATION
IN
.. City of Atlantic Beach Building Department GRAY IS REQUIRED.
s7_ 800 Seminole Rd, Atlantic Beach, FL 32233 IA ('��'( ci ._ C:). .--.-)\,n ` C:). .--.-)C:). .--.-)Phone: (904) 247-5826 Email: Building-Dept@coab.us coab.us PERMIT#:
p.��
JOB ADDRESS: 1945 BRISTA DE MAR CIRCLE Q PROJECT VALUES ,, 0 U-
❑NEW AIR CONDITIONING&HEATING SYSTEM INSTALLATION ARI It(REQUIRED)
0 Air Handling Equipment Only D 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
EIREPLACEMENT AIR CONDITIONING &HEATING SYSTEM INSTALLATION AR!It(REQUIRED) ova' Sy 1"--1 31-1
❑Air Handling Equipment Only 0 Condenser Only 0 Air Handling Unit& Condenser
Air Conditioning: Unit Quantity 1 Tons per Unit 50
Heat: Unit Quantity 1 BTU's Per Unit S bOOo Seer Rating(REQUIRED) \ 9See or-
Duct
Duct Systems: Total CFM
1FIRE 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)
nFIRE PLACES ("l MISCELLANEOUS:
Prefabricated Fireplace (Qty) Automobile Lifts
Gas Piping Outlets Boilers BTUs
Elevators/Escalators
❑ALL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets Pumps
If Vented Wall Furnaces Refrigerator Condenser BTUs
#Water Heaters Solar Collection Systems
Tanks(gallons)
Wells
OTHER: HVAC CHANGEOUT:GOODMAN 5TON 16 SEER \ C A
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 nat. The permit does not give authority to violate the provisions of any other state or
!oral law regulation construction or the performance of construction.
Owner Name:KEN SIMON Phone Number: 732-939-9908
Mechanical Company: EUTEAC LIG Office Phone: 3234611 Fax
Co.Address: 6060 CHESTER CIRCLE City: JACKSOMALLE State: FL Zip: 32217
License Holder: ROBERT GRANT S rtification/Registration#CAC1818659
Notarized Signature of License Holder d'
The foreggiqg instrument was acknowledged before me this 05 day o1 ,20/9 ,in the State of Florida,
County of yr :‘1,-, �J-7 �l 'i:.
Signature of Notary Publici.c..; /.• , /z-c-1 -,c--
a�•'••• JESSICAM.000FIi2AlI [ ]Personally Known ORI ] Produced Identification
..-'. .--45.‘,
A. , CanrriissanIGG338020 Type of Identification:
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^r ,,„ of Expires May 23 2023 Uodoted 10/9/18
"•-:FoiiY?�' Boded Pru Prey Fein!Durance 800485.7019
, --.sl-A1.-
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. - , Cash Register Receipt Receipt Number
'� ry v~ City of Atlantic Beach R10853
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DESCRIPTION I ACCOUNT I QTY PAID
PermitTRAK $127.00
ACRS19-0357 Address: 1945 BRISTA DE MAR CIR APN: 169506 1660 $127.00
MECHANICAL $123.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
AC AND REFRIGERATION 455-0000-322-1000 5 $40.00
FURNACES AND HEATING 455-0000-322-1000 56000 $28.00
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: R10853 $127.00
Date Paid: Friday, October 25, 2019
Paid By: Elite AC, LLC
Cashier: CB
Pay Method: CREDIT CARD 7
it
Printed: Friday,October 25, 2019 2:33 PM 1 of 1 ir