364 W 3rd St ACRS20-0012 • %'i"'"% MECHANICAL RESIDENTIAL HVAC PERMIT NUMBER
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PERMIT ACRs2o-0012
011,,,____}--) ISSUED: 1/13/2020
CITY OF ATLANTIC BEACH EXPIRES: 7/11/2020
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:
MECHANICAL RESIDENTIAL
364 W 3RD ST HVAC HVAC - 1 A/C, 1 AHU, 5 TON $5691.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
170865 0010 ATLANTIC BEACH SEC H
COMPANY: ADDRESS: CITY: STATE: ZIP:
OCEAN STATE HEAT& AIR, 1476 ATLANTIC BLVD NEPTUNE BEACH FL 32266
INC.
OWNER: ADDRESS: CITY: STATE: ZIP:
HARMER DAVID B 364 W 3RD ST ATLANTIC BEACH FL 32233-2508
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.
iw LIST OF CONDITIONS MIME
•
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
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DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
AC AND REFRIGERATION 455-0000-322-1000 5 $40.00
FURNACES AND HEATING 455-0000-322-1000 57000 $28.00
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
Issued Date: 1/13/2020 1 of 2
r ' Lxiri,, MECHANICAL RESIDENTIAL HVAC PERMIT NUMBER1 � ACRS20-0012
PERMIT
��1 �' ISSUED: 1/13/2020
\ '0.11, .[----- CITY OF ATLANTIC BEACH EXPIRES: 7/11/2020
TOTAL: $127.00
Issued Date: 1/13/2020 2 of 2
Mechanical Permit Application * ALL INFORMATION
i pp HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
'' _, ;) 800 Seminole Rd, Atlantic Beach, FL 32233 ` `
��' R C���Zo- 00 1 Z
`.' ' Phone: (904) 247-5826 Email: L'uuilJili .- tv, t@coala.u:s PERMIT#:
JOB ADDRESSYP44- 34- S-I- tioes i- PROJECT VALUE $ 5/-
9
NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION AR!#(REQUIRED)
❑Air Handling Equipment Only ❑ 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
1
REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI#(REQUIRED) C?�f 7 73
0 Air Handling Equipment Only 0 Condenser Only c,.. yKAir
Handling Unit& Condenser
Air Conditioning: Unit Quantity I Tons per Unit
Heat: Unit Quantity I BTU's Per Unit 5•4CCO Seer Rating (REQUIRED) 1i CO
Duct Systems: Total CFM
nFIRE PREVENTION
Fire Sprinkler System Quantity (Requires 3 sets of plans) 1 Q� D
Fire Standpipe Quantity (Requires 3 sets of plans) o
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)
rFIRE PLACES IT MISCELLANEOUS:
Prefabricated Fireplace (Qty) Automobile Lifts
Gas Piping Outlets Boilers BTUs
Elevators/Escalators
HALL 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. /rl�
Owner Name: �.()���- V1 6l1'(lti-ki. Phone Number: 2-T " 2,si(o
Mechanical Company: OCEAN STATE HEATING&AIR Office Phone: (904)249-8251 Fax(904)249-8949
CO.Address: 1476 ATLANTIC BLVD. City: NEPTUNE BEACH State: FL Zip: 32266
License Holder: J. GLENN JONE +' . - - - ' . ion/Registration# CAC049310
Notarized Signature of License Hol. • AV
The foregoing'gstruma,nt was .cknowledge. .- • .- -1 „day of javt ter" , 202-0, in the State of Florida,
Countyof
t.
_ _ _ _ _ ,,, Signature of Notary Public , L 01
4 ,,<,;'',, YVETTE P.MORALES
1 'z .c-: NotaryPublic-StateofFlorida [ lse�OWn OR [ ] Produced Identifkation
• '' Commission Si GG 069102
,�o:...,o`• My Comm.Expires Mar 2,2021 P Type of Identification:
' BonddthroughNationalNotaryAssn. Updated 10/9/18