1753 Live Oak Ln GSRS19-0105 MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
.:. r' PERMIT GSRS19-0105
ISSUED: 12/16/2019
CITY OF ATLANTIC BEACH EXPIRES: 6/13/2020
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:
GAS PIPING - 2 OUTLETS, 2
1753 LIVE OAK LN MECHANICAL RESIDENTIAL GAS WATER HEATERS, 2 $2900.00
FIREPLACES & TANK
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
172020 0186 SELVA MARINA UNIT 06
COMPANY: ADDRESS: CITY: STATE: ZIP:
AEI INTERNATIONAL CORP. 7709 ALTON AVE JACKSONVILLE FL 32211
OWNER: ADDRESS: CITY: STATE: ZIP:
SCOTT JOSEPH M 1201 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.
a
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 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
TANKS GAS OR LIQUEFIED PETROLEUM 455-0000-322-1000 250 $20.00
Issued Date: 12/16/2019 1 of 2
- ,,:c MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
GSRS19-0105
PERMIT
�J CITY OF ATLANTIC BEACH ISSUED: 12/16/2019 t
'%—usi19%' EXPIRES: 6/13/2020
VENTED WALL FURNACE WATER HEATER UNIT 455-0000-322-1000 4 $20.00
TOTAL: $109.00
Issued Date: 12/16/2019 2 of 2
*'"ALL INFORMATION
.-L`i'' Mechanical Permit Application HIGHLIGHTED IN
s GRAY IS REQUIRED. 6.
City of Atlantic Beach Building Department
i<Vir 800 Seminole Rd, Atlantic Beach, FL 32233 IRS i `l -0105
--:: ;1_,,,.),•,- Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: R19-0175
JOB ADDRESS: 1753 Live Oak Lane PROJECT VALUE $2,900.00
❑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
❑REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI#(REQUIRED)
❑Air Handling Equipment Only 0 Condenser Only 0 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
I '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 IT MISCELLANEOUS:
Prefabricated Fireplace (Qty) Automobile Lifts
Gas Piping Outlets 2 Boilers BTUs
Elevators/Escalators
[ ALL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets 4 Pumps
#Vented Wall Furnaces Refrigerator Condenser BTUs
# Water Heaters 2 Solar Collection Systems
Tanks (gallons)
Wells
Q OTHER: Total of 6 Outlets,(2)Tankless Water Heaters,(2)Fireplaces,Range.Dryer. 250 Propane Gas Tank
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. c �
Owner Name: RIVERSIDE HOMES Phone[.� Nu7mber: a`' (' gil '" 8t
Mechanical Company: AEI GAS SERVICES Office Phone: 9t, / J ��fl(Fax
Co. Address: 7709 ALTON AVE City: JACKSONVILLE State: FL Zip: 32211
License Holder: BELINDA SPRADLIN State Certification/Registration # 9917
Notarized Signature of License Holder �AC JX-G/iy.k..1.--- / /
The foregoirkg\instrum nt was acknowledged before me this ! '?lay of " 0,41\014' , 20 Li in the State of Florida,
County of ��l>/
Signature of Notary Public_> �j1s� ��J(
Notary Public State of Florida
Stephanie E Carter ' Personally Known OR [ ] Produced Identification
j� EMyxp Creaommiefio
07t812022n GG 239425 ype of Identification:
an
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Updated 10/9/18
IrJS'- .
sf Cash Register Receipt Receipt Number
City of Atlantic Beach R11305
\`t) Uir
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $109.00
GSRS19-0105 Address: 1753 LIVE OAK LN APN: 172020 0186 $109.00
MECHANICAL $105.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
VENTED WALL FURNACE WATER HEATER
455-0000-322-1000 4 $20.00
UNIT
TANKS GAS OR LIQUEFIED PETROLEUM 455-0000-322-1000 250 $20.00
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: R11305 $109.00
Date Paid: Monday, December 16, 2019
Paid By: AEI INTERNATIONAL CORP.
Cashier: CB
Pay Method: CREDIT CARD 14
No
Printed: Monday, December 16,2019 3:31 PM 1 of 1 TO