177 Sailfish Dr GSRS19-0094 withdrawn gas permit rs'='''' -,t, MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
' _, GSRS19-0094
�� . PERMIT
K'',,
ISSUED: 11/8/2019
CITY OF ATLANTIC BEACH EXPIRES: 5/6/2020
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:
177 SAILFISH DR MECHANICAL RESIDENTIAL GAS GAS PIPING 2 OUTLETS $1150.00
AND 2 100 LB TANKS
TYPE OF I REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: = NUMBER: GROUP:
177607 0000 SECTION LAND
COMPANY: ADDRESS: CITY: STATE: ZIP:
AEI INTERNATIONAL CORP. 7709 ALTON AVE JACKSONVILLE FL 32211
OWNER: ADDRESS: CITY: STATE: ZIP:
TIERNAN MICHAEL P 5424 CLIFTON RD JACKSONVILLE FL 32211
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
i
GAS PIPING OUTLETS 455-0000-322-1000 2 $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 200 $20.00
TOTAL:$89.00
Issued Date: 11/8/2019 1 of 2
- ':li-A`'r,' MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
I` _ °14
PERMIT GSRS19-0094
.;i••-•••y ' ISSUED: 11/8/2019
s3 CITY OF ATLANTIC BEACH EXPIRES: 5/6/2020
Issued Date: 11/8/2019 2 of 2
MECHANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
•
Ph (904) 247-5826 Fax (904) 247-5845
ros ADDRESS:- al 5k Dr. R S( 9 _a0
PERMIT#
PROJECT VALUE $_ 1 \5=LGQ
ARI# REQUIRED
_Air Handling Equipment Only Air Handling Unit & Condenser
tEW AIR CONDITIONING & HEATING SYSTEM Condenser Only
Air Conditioning: Unit QuantityINSTALLATION
Heat: --_ Tons Per Unit
Heat Systems: Tott Quantity BTU's Per Unit
i;
CFM
_ Seer Ratin
REQUIRED
EPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATIO
Air Conditioning: Unit Quantit N
Heat: } Tons Per Unit
Heat Systems: Unit Quantit} BTU's Per Unit --
CF
Seer Rating
REQUIRED
RE PREVENTION
Fire Sprinkler System Quantity
(Requires 3 sets of plans)
Fire Standpipe Quantity
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)
(Requires 3 sets of plans)
2E PLACES MISCELLANEOUS:
Prefabricated Fireplace Qty
Gas Piping Outlets Automobile Lifts
Boilers BTU's
L OTHER GAS PIPING Elevators/Escalators
Quantity of Outlets Heat Exchanger
# Vented Wall Furnaces � Pumps
# Water Heaters Refrigerator Condenser BTU's
Solar Collection Systems
Tanks(gallons)
Wells (i..._
HER: ,y\Pit k ara CoN \,` . WO \‘'s2) i s
becomes void if work does not commence‘vithin a six month period or work is suspended or abandoned for six months. 1 hereby certify that I have read
plication 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
he permit does not give authority to violate the provisions of any of er tate or local la.‘ regulation construction or the performance of construction.
.ity Owners Name 1--' RT\,Q��uC i c�,r-5 Phone
NumberaN-196161"19G
ianical Company GCLS SVV i C.0.5 Office Phon0)-14-S111 ax 1 -3„3- 0
.ddress:-1''16 q 1-\--CAN
CitN()),l Q__State nZip
tse Holder(Print): �/( de- --50 i4 d // n State Certification/Registration# 1 cii rl__
ized Signature of License Holder � 4,--;1/4"— ` �2
ger 4Ni_ notary Public State of Florida efore me this day o OV bilk 20
r 4'71 Stephanie E Carter
s� MyCommiuiOnGG23W25 ignature of Notary Public \
fr/a exprea 07/tt1/2022 _ v
js rS rL�JrI r
41 I` �� Cash Register Receipt Receipt Number
si
�'V Z City of Atlantic Beach R11O21
DESCRIPTION ACCOUNT I QTY PAID
PermitTRAK $89.00
GSRS19-0094 Address: 177 SAILFISH DR APN: 177607 0000 $89.00
MECHANICAL $85.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
TANKS GAS OR LIQUEFIED PETROLEUM 455-0000-322-1000 200 $20.00
GAS PIPING OUTLETS 455-0000-322-1000 2 $10.00
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: R11021 $89.00
Date Paid: Friday, November 08, 2019
Paid By: AEI INTERNATIONAL CORP.
Cashier: CT
Pay Method: CREDIT CARD 9
Printed: Friday, November 08, 2019 1:19 PM 1 of 1