377 12th St ACRS19-0369 t''''''%, MECHANICAL RESIDENTIAL HVAC PERMIT NUMBER
', '-,' ACRS19-0369 '
:..Y, :. PERMIT
si�r� 5ISSUED: 11/8/2019
t>r 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:
MECHANICAL RESIDENTIAL replace 3.5 ton 41K BTU
377 12TH ST HVAC AHU & 1.5-ton 18.5K-BTU $7453.00
AHU
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
171920 0000 SELVA MARINA UNIT 01
COMPANY: ADDRESS: CITY: STATE: ZIP:
ENVIRONMENTAL AIR 8110 CYPRESS PLAZA DR STE 106 JACKSONVILLE FL 32256
SERVICES,INC
OWNER: ADDRESS: CITY: STATE: ZIP:
TOMSON WILLIAM 377 12TH ST ATLANTIC BEACH FL 32233
THEODORE ET AL
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
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
AC AND REFRIGERATION 455-0000-322-1000 5 $40.00
FURNACES AND HEATING 455-0000-322-1000 59500 $28.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
Issued Date: 11/8/2019 1 of 2
i' vi,- MECHANICAL RESIDENTIAL HVAC PERMIT NUMBER
Aiiit�
PERMIT
3 .,,
ACRS19-0369
� ISSUED: 11/8/2019
�,j, ,r CITY OF ATLANTIC BEACH EXPIRES: 5/6/2020
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: 11/8/2019 2 of 2
r ir Mechanical Permit Application *"ALL INFORMATION
" HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
'� /-' 800 Seminole Rd, Atlantic Beach, FL 32233
-jiir'r Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: Pte-
`e-rcn"SI L(�
w3(10`,
JOB ADDRESS: 377 12th Street,Atlantic Beach,FL 32233 PROJECT VALUE $7,453.00
❑NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI#(REQUIRED)
0 Air Handling Equipment Only 0 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
ITREPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI#(REQUIRED) 10093539
❑ Air Handling Equipment Only ❑ Condenser Only p Air Handling Unit& Condenser
Air Conditioning: Unit Quantity 2 Tons per Unit 354,r—
Heat: Unit Quantity-a 2 BTU's Per Unit 41.000`(y rbc Seer Rating (REQUIRED) 16.00
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)
(FIRE PLACES E MISCELLANEOUS:
Prefabricated Fireplace (Qty) Automobile Lifts
Gas Piping Outlets Boilers BTUs
Elevators/Escalators
nALL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets Pumps
#Vented Wall Furnaces Refrigerator Condenser BTUs
#Water Heaters Solar Collection Systems
Tanks (gallons)
Wells
OTHER:
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 not. The permit does not give authority to violate the provisions of any other state or
local law regulation construction or the performance of construction.
Owner Name:Bill&Anne Tomson Phone Number: (904)853-6985
Mechanical Company: Dominion Air dba EAC Services Office Phone: (904)279-0030 Fax(904)279-0078
Co. Address: 8110 Cypress Plaza Drive,Suite 106 City: Jacksonville State: FL Zip: 32256
License Holder: Howard K. Stalls,Jr. ill /j State Certification/Registration# CAC057409
Notarized Signature of License Holder
The foregoin Instrument was acknowledged before me is . ..y of , 2Q-\ , in the State of Florida,
County of �a� — —�>
Signature of Nota , •. . is - ,.\ \ct- ,ra`�'i
s•:4,-tip ,; KAYVEGA•NAVARRO �• Personally Known OR [ ] Produced (dent fi Ic 'on c \,
r f, Commisslon#GG 238930 ype of Identification:
_;5•: J Expires July 11,2022
.P",;:" Wed Tiro Troy Fain Munro 800.3857019 Updated 10/9/18