606 Coastal Oak Ln GSRS19-0101 , MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
tf GSRS19-0101
� o PERMIT ISSUED: 12/9/2019
;, ! CITY OF ATLANTIC BEACH EXPIRES: 6/6/2020
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:
6 OUTLETS & 2 WATER
606 COASTAL OAK LN MECHANICAL RESIDENTIAL GAS HEATERS FOR NEW SINGLE $1985.00
FAMILY HOME
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
169505 2010 ATLANTIC BEACH
COUNTRY CLUB UNIT 02
COMPANY: ADDRESS: CITY: STATE: ZIP:
CONSTRUCTION
SOLUTIONS &SUPPLY, LLC 5225 EDGEWOOD CT JACKSONVILLE FL 32254
OWNER: ADDRESS: CITY: STATE: ZIP:
DAVID SCOTT ARNOLD 3528 VALVEREDE CIRCLE JACKSONVILLE FL 32224
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 6 $14.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
Issued Date: 12/9/2019 1 of 2
4 e". MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
GSRS19-0101
,
ISSUED: 12/9/2019
�y ,� PERMIT CITY OF ATLANTIC BEACH EXPIRES: 6/6/2020
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
VENTED WALL FURNACE WATER HEATER UNIT 455-0000-322-1000 2 $10.00
TOTAL:$83.00
Issued Date: 12/9/2019 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 cc
JOB ADDRESS: Cc,('')CD e-ocx --ci\ �)c..kt _ PERMIT# 6.Sre.SII —OI q
PROJECT VALUE $ I c15 ; 'c' 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 PIPIN Heat Exchanger
Quantity of Outlets . n T -k-c Pumps
# Vented Wall Furnaces Refrigerator Condenser BTU's
# Water Heaters -7.7cLh 1r\\_‘.._ �_) Solar Collection Systems
Tanks (gallons)
'Wells 1 (�
C:31 OTHER: 01-0,,( is)s)r-pDckk'
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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
lot. The permit does not give authority to violate the provisions ofan other state or cal law regulation construction or the performance of construction.
Property Owners Name .S Y
; \ Av (1o Phone Number
Vlechanical Company c;,n5A-r tAcAtion5c1, DA-;Dec' 5,,,�,� A Office Phone 3S 76c) Fax 3gy- d717
:o. Address:,5 01.A,'S 'F.,Ae\xx-A C--. City ack3bt l';N.State FL_ Zip 3,2c
License Holder(Print): 'rte c)nl fes+ ,State Certification/Registration#m/12_02
S7
lifer / �� .1.e_s
i.iiii, DAWNYELL R.WA INS
;r• .I commissions Be`ore me this day ofd-c.e�vl 1p. I 20 lei
�_Expires July 8.2023
ft.!*'. 13(14.4 Thu troy Fab'War"'4.385." 1 7 Lv
Signature of Notary Public y QC, -N-IyLe t ac ',frd
i'-tvii-
sr
nl Cash Register Receipt Receipt Number
City of Atlantic Beach R11247
DESCRIPTION I ACCOUNT I QTY I PAID
PermitTRAK $83.00
GSRS19-0101 Address: 606 COASTAL OAK LN APN: 169505 2010 $83.00
MECHANICAL $79.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
GAS PIPING OUTLETS 455-0000-322-1000 6 $14.00
VENTED WALL FURNACE WATER HEATER
455-0000-322-1000 2 $10.00
UNIT
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: R11247 $83.00
Date Paid: Monday, December 09, 2019
Paid By: CONSTRUCTION SOLUTIONS &SUPPLY, LLC
Cashier: CB
Pay Method: CREDIT CARD 1
or
Printed: Monday, December 09,2019 1:20 PM 1 of 1 ti