10 10TH ST #65 16-MECH-501 duct work permit ,( r'T r\i`J J
� ''� ��f CITY OF ATLANTIC BEACH
0 ;-) 800 SEMINOLE ROAD
;" ATLANTIC BEACH, FL 32233
N INSPECTION PHONE LINE 247-5814
MECHANICAL HVAC PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-MECH-501
Job Type: MECHANICAL HVAC ONLY
Description: duct work only
Estimated Value:
Issue Date: 3/1/2016
Expiration Date: 8/28/2016
PROPERTY ADDRESS:
Address: 10 10TH ST 65
RE Number: 170237-0142
PROPERTY OWNER:
Name: FORT, ELIZABETH LEE
Address: 10 10TH ST APT 65
GENERAL CONTRACTOR INFORMATION:
Name: AIR FLOW DESIGNS NORTH, LLC
Address: PO BOX 180308 QA TERRY HILE BURD
Phone: - -
PERMIT INFORMATION: Sticker for overcurrent protection must be on A/C equipment prior to
inspection. Failure to comply will result in a failed inspection and reinspect fees. No
exceptions.
FEES:
Trade Permit Base Fee $55.00
State Mech DCA Surcharge $2.00
State Mech DBPR Surcharge $2.00
Heat Exchanger or Coil in Ducts $10.00
Total Payments: $69.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
MECHANICAL PERMIT APPLICATION VA-0 /33
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904)247-5826 Fax (904)247-5845
� 3zZ JOB ADDRESS: f a *.y/-h ,5f` ZUi,;f (or S !'/acl l Bch l
PERMIT#/6--RAii-X - is/
PROJECT VALUE$ 3, o (19. o 0
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
ARI#
Air Conditioning: Unit Quantity Tons Per Unit REQUIRED
Heat: Unit Quantity BTU's Per Unit Seer Rating
Duct Systems: Total CFM 5100 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 Pumps
#Vented Wall Furnaces Refrigerator Condenser BTU's
#Water Heaters Solar Collection Systems
Tanks(gallons)
Wells
OTHER: Du-e i 600,--,4 0A/ /y
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}mow 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 autho'ty to violate the provisions of any other state or local law regulation construction or the performance of construction.
Property Owners Name C p be-11 Phone Number*Y-76?-q30 2
Mechanical Company ii-'r F/0c.) Dv Office PhonV-3If Fax
Co.Address:5(,/Sa 3-/-09... 1.4,3.9,-4t____ City, Je%)( StatK Zip 32247
License Haider(Print): State Certification/Registration#C09-G/P/qq
Notarized Signature o f License Holder ��
Sworn and subscribed before me / s� day of iv('t/t(-IL— 20 A
Signature of Notary blic #5-4-----8n �"Y
i:•r''••. DONNA L.THOMASON
T rm • Commission#FF 138497
.-�• Expires November 2,2018
. -'' BadW That Troy Fan Insurance 8004E5.7019