57 Sherry Dr GSRS19-0104 Cooktop/Fireplace s'' r% MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
"" PERMIT GSRS19-0104
�'ij ISSUED: 12/12/2019�;;�,; CITY OF ATLANTIC BEACH EXPIRES: 6/9/2020
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:
S - HERRY DR MECHANICAL RESIDENTIAL GAS GAS PIPNG COOKTOP & $675.00
.58-SHERRY
FIREPLACE
TYPE OF 1 REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
169756 0000 ATLANTIC BEACH
COMPANY: ADDRESS: CITY: STATE: ZIP:
CONSTRUCTION 5225 EDGEWOOD CT JACKSONVILLE FL 32254
SOLUTIONS & SUPPLY, LLC
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.
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
GAS PIPING OUTLETS 455-0000-322-1000 1 $10.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
PREFABRICATED FIREPLACES 455-0000-322-1000 1 $30.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
Issued Date: 12/12/2019 1 of 2
s
�5 ','r MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
�µ L_t. PERMIT GSRS19-0104
uv zo. ISSUED: 12/12/2019
x Jf3 ,; CITY OF ATLANTIC BEACH EXPIRES: 6/9/2020
TOTAL: $99.001
Issued Date: 12/12/2019 2 of 2
r--
s' Cash Register Receipt Receipt Number
'`°40City of Atlantic Beach R11278
DESCRIPTION I ACCOUNT I QTY I PAID
PermitTRAK -7 $99.00
GSRS19-0104 Address: 53SHERRY DR APN: 169756 0000 $99.00
MECHANICAL $95.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
GAS PIPING OUTLETS 455-0000-322-1000 1 $10.00
PREFABRICATED FIREPLACES 455-0000-322-1000 1 $30.00
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: R11278 $99.00
Date Paid: Thursday, December 12, 2019
Paid By: CONSTRUCTION SOLUTIONS & SUPPLY, LLC
Cashier: CT
Pay Method: CREDIT CARD 030857
to
Printed:Thursday, December 12,2019 3:25 PM 1 of 1 t,
GSRS 9 - 0( o4
(--,,,,,,,p, ,. Mechanical Permit Application **ALL INFORMATION
-4HIGHLIGHTED IN
" City of Atlantic Beach Building Department GRAY IS REQUIRED.
`,, ' 800 Seminole Rd, Atlantic Beach, FL 32233 S lz l��
` ' crisc Phone: (904) 247-5826 Email: Buildin -Det coab.us (V- —6Z1-� 2
p @ PERMIT#: 1
JOB ADDRESS: 7 k Q r rL3 b I` , PROJECT VALUE$ L015 i
0 NEW AIR CONDITIONING&HEATING SYSTEM INSTALLATION ARI#(REQUIRED)
❑Air Handling Equipment Only 0 Condenser Only 17 Air Handling Unit&Condenser
Air Conditioning: Unit Quantity Tons per Unit
Heat: Unit Quantity BTUs per Unit Seer Rating(REQUIRED)
Duct Systems: Total CFM
DREPLACEMENT AIR CONDITIONING& HEATING SYSTEM INSTALLATION ARI#(REQUIRED)
❑Air Handling Equipment Only 0 Condenser Only p Air Handling Unit&Condenser
Air Conditioning: Unit Quantity Tons per Unit
Heat: Unit Quantity BTU's Per Unit Seer Rating(REQUIRED)
Duct Systems: Total CFM
❑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 BTUs
Elevators/Escalators
ALL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets _a___ Pumps
#Vented Wall Furnaces Refrigerator Condenser BTUs
#Water Heaters Solar Collection Systems
Tanks (gallons)
11 Wells
OTHER: * •
—C5c, 11�t��c, s ( , rc I ac.-0--
Permit
G -
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: fn on1 Gam- -h i.z. V`k\\( t {`S Phone Number:
Mechanical Com anSod qv'I
P Y e. r L\c -�c-IrnN Jco 1� -' -fri`.) c Office1 Phone: 38ci-1 1 C)0 Fax 3�-(Vr2
Co.Address: ti c 1i:�DCC�, l _ Kp ��53
ity: �10�c./�s anU I' l iq State: a zip: 3A-25 L(
License Holder: yz I (' ,Ito State Certification/Registration it alp 1 P S
Notarized Signa of re of License Holder,j (Y1 K I'PC* CI
The foregoing instrument was acknowledged before me this 1 as day of TATO-0(K 201(1, in the State of Florida,
County of M k\)CU
Signature of Notary Publi a,ttAt/i-Dr 1
;rr;.;i t,, JESSI N.RAULERSON
'��'•.,•'•'• MY COMMISSION#GG 314245 Personally Known OR [ ] Produced Identification
' ;a•.%1� ? EXPIRES:June 25,2023
:?IEORM1OP,; Bonded ThruNota Wanders antlers Type of Identification:
- s ♦- w r Updated 10/9/18