55 Sherry Dr GSRS19-0098 2 Outlets ri'�''\., MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
firi PERMIT GSRS19-0098
V
" ISSUED: 12/2/2019
\;1,.ni ,. CITY OF ATLANTIC BEACH EXPIRES: 5/30/2020
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:
55 SHERRY DR MECHANICAL RESIDENTIAL GAS GAS PIPING 2 OUTLETS, $695.00
(COOKTOP & FIREPLACE)
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
169756 0000 ATLANTIC BEACH
COMPANY: ADDRESS: CITY: STATE: ZIP:
CONSTRUCTION
SOLUTIONS & SUPPLY, LLC 5225 EDGEWOOD CT JACKSONVILLE FL 32254
OWNER: ADDRESS: CITY: STATE: ZIP:
AF AB VENTURE LLC 1738 SELVA MARINA DR NEPTUNE BEACH FL 32266
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
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
TOTAL: $69.00
Issued Date: 12/2/2019 1 of 2
?�, -, MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
PERMIT GSRS19-0098
1 " ISSUED: 12/2/2019
�s ,. CITY OF ATLANTIC BEACH EXPIRES: 5/30/2020
Issued Date: 12/2/2019 2 of 2
MECHANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233 S R S9_0098
Ph(904) 247-5826 Fax (904) 247-5845 l
JOB ADDRESS: S S sh rr r 11 , PERMIT#R Li
PROJECT VALUE $ in 9S'co ARI# REQUIRED
Air Handling Equipment Only Air Handling Unit & Condenser Condenser Only
NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity Tons Per Unit
Heat: Unit Quantity BTU's Per Unit Seer Rating
Duct Systems: Total CFM REQUIRED
REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity Tons Per Unit
Heat: Unit Quantity BTU's Per Unit Seer Rating
Duct Systems: Total CFM REQUIRED
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 Qty Automobile Lifts
Gas Piping Outlets Boilers BTU's
Elevators/Escalators
ALL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets c . -(- Pumps
# Vented Wall Furnaces Refrigerator Condenser BTU's
# Water Heaters Solar Collection Systems
Tanks (gallons)
Wells
OTHER: Po -R. -40C a ()r p - C-C?ok+o., i F r+ 0(\c-e. ( H Oto 0 o RTU) s�
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 theitprovisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name n c�a-h i 2k.(? \)j. c--4, Phone Number
l�
clo41-38q- (:\09-381
Mechanical CompanyCC�rl4,t`` t,`�c,�,i nn So),),- 0x-61 6:\tkij01 Office Phone .?co-ey\Z1 Fax 0,27-7
Co. Address: a of to ks,,,,,cnn��i t C,-. City 1c c,�4cp,\V i\`i State L zip I 5 9
License Holder(Print): i rr1 ck o rest,{( /State Certification/Registration#a&667
Votari7et( ,alar Q f z ileder / �-.j�- --- _.r /11,4s
1 ;jt?'""•' ;, DAWNYELLRWA?KINS
? #GG35V71 Be`ore me this a 5 day of MVP,vy7 bey 20
'� • ' Jul $,2023
-...f s, Uoyfal ____t045.1019 Signature of Notary Public i >a, At---na,p,Q,F Lt)jI
,it'''' `fir/�i
,,
Cash Register Receipt Receipt Number
~ City of Atlantic Beach R11163
DESCRIPTION I ACCOUNT I QTY I PAID
PermitTRAK $69.00
GSRS19-0098 Address: 55 SHERRY DR APN: 169756 0000 $69.00
MECHANICAL $65.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
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: R11163 $69.00
Date Paid: Monday, December 02, 2019
Paid By: CONSTRUCTION SOLUTIONS & SUPPLY, LLC
Cashier: CT
Pay Method: CREDIT CARD 020938
Printed: Monday, December 02, 2019 10:25 AM 1 of 1 j