632 Main St ACRS20-0017 r,"' MECHANICAL RESIDENTIAL HVAC PERMIT NUMBER
' ACRS20-0017
PERMIT ISSUED: 1/16/2020
./ CITY OF ATLANTIC BEACH EXPIRES: 7/14/2020
�Oi31 � nava 1 ( 140/2(_)
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:
632 MAIN ST MECHANICAL RESIDENTIAL HVAC - 1 A/C, 1 AHU, 2.5 $3000.00
HVAC TON
REAL ESTATE
TYPE OF BUILDING USEZONING: SUBDIVISION:
CONSTRUCTION: I NUMBER: GROUP:
170915 1000 ATLANTIC BEACH SEC H
COMPANY: I ADDRESS: CITY: STATE: ZIP:
BOLD CITY HEATING AND
AIR INC 837 Mendoza Drive Jacksonville FL 32217
OWNER: ADDRESS: CITY: STATE: ZIP:
WEST BRANDON P 632 MAIN ST ATLANTIC BEACH FL 32233-2532
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
AC AND REFRIGERATION 455-0000-322-1000 2.5 $16.00
FURNACES AND HEATING 455-0000-322-1000 30000 $24.00
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: 1/16/2020 1 of 2
,,,,.:1I-IVI'i, MECHANICAL RESIDENTIAL HVAC PERMIT NUMBER
r PERMIT ACRS20-0017 '
..: ISSUED: 1/16/2020
r��,j,r
CITY OF ATLANTIC BEACH EXPIRES: 7/14/2020
TOTAL:$99.00
Issued Date: 1/16/2020 2 of 2
„ ,,-77-,--,„ Mechanical Permit Application "ALL INFORMATION
`� HIGHLIGHTED IN
'\ City of Atlantic Beach Building Department GRAY IS REQUIRED. _
/J' 800 Seminole Rd,Atlantic Beach, FL 32233C -i �� ��
- Phone:(904) 247-5826 Email:Building-Dept@coab.us PERMIT#:
JOB ADDRESS: 632 Main St PROJECT VALUE$3,000.00
❑NEW AIR CONDITIONING&HEATING SYSTEM INSTALLATION ARI#(REQUIRED)
0 Air Handling Equipment Only 0 Condenser Only ❑Air Handling Unit&Condenser
Air Conditioning: Unit Quantity Tons per Unit
Heat: Unit Quantity BTUs per Unit Seer Rating(REQUIRED)
Duct Systems: Total CFM
0 REPLACEMENT AIR CONDITIONING&HEATING SYSTEM INSTALLATION ARI II(REQUIRED)9162305
❑Air Handling Equipment Only 0 Condenser Only ❑Air Handling Unit&Condenser
Air Conditioning: Unit Quantity Tons per Unit 2.5
Heat: Unit Quantity BTU's Per Unit 30 Seer Rating(REQUIRED)1400
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) 1
� `_ ,/”❑FIRE PLACES nMISCELLANE0U5: t
Prefabricated Fireplace(Qty) Automobile Lifts (...7.4
Gas Piping Outlets Boilers BTUs
Elevators/Escalators
❑ALL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets Pumps
U 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:Brandon West Phone Number:(9041 537-5790
Mechanical Company:Bold Cay Heating and Air Office Phone:(904)379-1648 Fax
Co.Address:6900 Philips Hwy 52 City:Jan State:FL Zip:32216
License Holder: Mirza Pilakovic State Certification/Registration#CAC1818833
Notarized Signature of License Holder
The foregoing instrument was acknowledged before me this 1Q 'day of Scei"\ ,20/0,in the State of Florida,
County of ---
Signature of Notary Public
(Personally Known OR I j Produced Identification
+ EMINA PILAKOVIC Type of Identification:
'. '. '•c MY COMMISSION r OGp88740 Updoted 10/9/18
'„...":614". EXPIRES March 26,2021
l/JI rs-, Cash Register Receipt Receipt Number
City of Atlantic Beach R11492
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $99.00
ACRS20-0017 Address: 632 MAIN ST APN: 170915 1000 $99.00
MECHANICAL $95.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
AC AND REFRIGERATION 455-0000-322-1000 3 $16.00
FURNACES AND HEATING 455-0000-322-1000 30000 $24.00
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: R11492 $99.00
Date Paid: Thursday,January 16, 2020
Paid By: BOLD CITY HEATING AND AIR INC
Cashier: CT
Pay Method: CREDIT CARD 018617
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Printed:Thursday,January 16, 2020 3:27 PM 1 of 1