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2133 SEMINOLE RD #1 - GSRS19-0103 r-* MECHANICAL RESIDENTIAL GAS PERMIT NUMBER PERMIT GSRS19-0103 _x-11✓ ISSUED: 12/12/2019 J� r ;;�;��� 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: : 2133 SEMINOLE RD 1 MECHANICAL RESIDENTIAL GAS GAS PIPING - FIREPLACE $3184.00 TYPE OF REAL ESTATE i ZONING: BUILDING USE SUBDIVISION: CONSTRUCTION: NUMBER: GROUP: 169515 0430 SECTION LAND COMPANY: ADDRESS: CITY: STATE: ZIP: SETZERS & COMPANY 7660 PHILLIPS HWY JACKSONVILLE FL 32241 OWNER: ADDRESS: CITY: STATE: ZIP: COOPER DIANNE 2133-1 SEMINOLE RD ATLANTIC BEACH FL 32233 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. . f.a DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT 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 TOTAL: $89.00 Issued Date 12/12/2019 1 of 2 Mechanical Permit Application **ALL INFORMATION HIGHLIGHTED IN "i City of Atlantic Beach Building Department GRAY IS REQUIRED. = 800 Seminole Rd, Atlantic Beach, FL 32233 Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: 2133 Seminole rdb•iit 2 •--- $3184.15 JOB ADDRESS: l PROJECT VALUE ❑NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI#(REQUIRED) ❑Air Handling Equipment Only G 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 DREPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI#(REQUIRED) ❑Air Handling Equipment Only 0 Condenser Only ❑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 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 ❑MISCELLANEOUS: Prefabricated Fireplace (Qty) x Automobile Lifts Gas Piping Outlets Boilers BTUs Elevators/Escalators EAU_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:Dianne Cooper Phone Number: 904-472-5361 Mechanical Company: Setzers Office Phone: 904-731-4100 Fax904-730-8935 Co.Address: 7660 Philips Hwy City: Jacksonville State: FL Zip: 32256 License Holder: Berry Roberts tate Certification/Registration# 30560 Notarized Signature of License Holder �'% The foregoing instrument was acknowledged before me this L✓'t Islay of-Der-cm beciof j, in the State of Florida, County ofu Signature of Notary Public\-r :t 61 J Q��C�JLt "'"'P MELINDAL.GALLUP Known OR [ ] P duced Iden •fic 'on : : MY COMMISSION#GG 284853 V,)ersonally e of Identification: EXPIRES:Apri116,2023 Updated 10/9/18 •.',fo °,' Bonded Thru Notary Public Underwriters � Cash Register Receipt Receipt Number 157441 City of Atlantic Beach R11271 F va DESCRIPTION I ACCOUNT QTY PAID PermitTRAK $89.00 GSRS19-0103 Address: 2133 SEMINOLE RD UNIT 2 APN: 169515 0425 $89.00 MECHANICAL $85.00 MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00 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: R11271 $89.00 Date Paid: Thursday, December 12, 2019 Paid By: SETZERS & COMPANY Cashier: CT Pay Method: CHECK 5251 /xr Printed:Thursday,December 12, 2019 10:04 AM 1 of 1 NOTICE OF COMMENCEMENT (PREPARE IN DUPLICATE) Permit No. Tax Folio'No. f(pci 61 s5 -Du State of County of 1)1A04 L To whom it may concern: The undersigned hereby informs you that improvements will be made to certain real property,and in accordance with Section 713 of the Florida Statutes,the following Information is stated In this NOTICE OF COMMENCEMENT. � f Legal description of property being improved: �c> `` V 0 `�� (�� — (;A q -L2 S, 13yf fir &yr Lot I -)2_EGO f K 1");7--5 -, 3 Address of property being improved: 213 3 Se,/)4,v1 L PO /44./4"Pe 5i ii ��L 32233 General description of improvements: Y2‘LMOt/� 12 f/ACL 1,000e) �3l(Rtir,vs Owner i j j AJL Cog P 2 Address A..3 1;6' )240 '* /3--,,Azh t2 32 2_3 Owners interest in site of the improvement Fee Simple Titleholder(if other than owner) Name Address Contractor 13E-Y4acy Zfl /fly,/:DC Address T7 EPb/j,S /4i/ 370 Phone No. `c-34/ Fax No. 5Y 7?©^Q 93.5- Surety(if any) Address Amount of bond$ Phone No. Fax No. Name and address of any person making a loan for the construction of the improvements. Name Address Phone No. Fax No. Name of person within the State of Florida,other than himself or herself,designated by owner upon whom notices or other documents may be served: Name Address Phone No. Fax No. In addition to himself or herself,owner designates the following person to receive a copy of the Lienor's Notice as provided in Section 713.06(2)(b),Florida Statutes.(Fill in at Owner's option). Name Address Phone No. Fax No. Expiration date of Notice of Commencement(the expiration date is one(1)year from the date of recording unless a different date is specified): F 0 Llys ni THIS SPACE FOR RECORDER'S USE ONLY OWNER Signed: )(ao,di DATEi',�-ia-j q ai c " Doc#2019282247,OR BK 19032 Page 1583, Before me this 104A bay of c_e,h htT _.10 lc( in the J Coin of Duval,State of Flolt'da,has personally appeared Number Pages: 1 D C+• tr it r. l.a�e p herein ty o 8 4s I Recorded 12/10/2019 03:50 PM, himself/herself and affirms that all statements and declarations herein RONNIE FUSSELL CLERK CIRCUIT COURT DUVAL are true and accurate COUNTY RECORDING $10.00 1JC��'.Q�J�(��-(C► U1 Nota Publi at Large Stat Coun of UE]tc V t( r *robo. My commission expires: A p rr i Y(1 0 -•v eiPersonally Known or ;„•.• 1W: Produced Identification °;r. ....:•' ���0 'di° 6b � 17SC