83 Nicole Ln ACRS20-0027 .s MECHANICAL RESIDENTIAL HVAC411EPERMIT NUMBER
��`\, ACRS20-0027
y PERMIT
7 ISSUED: 1/28/2020
;j9� CITY OF ATLANTIC BEACH EXPIRES: 7/26/2020
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
83 NICOLE LN HVAC HVAC - 1 A/C, 1 AHU, 3 TONS $4998.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
169519 0825 TIFFANY BY THE SEA
COMPANY: ADDRESS: CITY: STATE: ZIP:
A/C DESIGNS OF ST 3370 AGRICULTURE CENTER DR ST.AUGUSTINE FL 32092
AUGUSTINE
OWNER: ADDRESS: CITY: STATE: ZIP:
WALSH SUSAN 83 NICOLE LN ATLANTIC BEACH FL 32233-5979
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.
FEES iiiiit
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
AC AND REFRIGERATION 455-0000-322-1000 3 $24.00
FURNACES AND HEATING 455-0000-322-1000 34200 $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: 1/28/2020 1 of 2
MECHANICAL RESIDENTIAL HVAC PERMIT NUMBER
1 ` 1. PERMIT ACRS20-0027
‘44;‘
' - ISSUED: 1/28/2020
4'141 = CITY OF ATLANTIC BEACH EXPIRES: 7/26/2020
TOTAL: $107.00
Issued Date: 1/28/2020 2 of 2
MECHANICAL PERMIT APPLICATION
OCITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach,FL 32233
Ph(904)247-5826 Fax (904)247-5845
JOB ADDRESS: 83 NICOLE LANE PERMIT# A QRSZO -00Z7
201680118
PROJECT VALUE $4998 , ARI# REQUIRED
__Air Handling Equipment Only X Air Handling Unit & Condenser Condenser Only
NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: l.nit Quantity Tons Per Unit
Heat: l.Jnit Quantity BTU's Per Unit Seer Rating
Duct Systems: Total CFM REQUIRED
REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: unit Quantity 1 Tons Per Unit 3
Heat: Unit Quantity 1 BTU's Per Unit 342 Seer Rating 16
Duct Systems: Total CFM N/A 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
&LL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets Pumps
#Vented Wall Furnaces Refrigerator Condenser BTU's
#Water Heaters Solar Collection Systems
Tanks(gallons)
Wells
ETHER:
'ermit 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
his application and know the same to he true and correct. All provisions of laws and ordinances governing this work will be complied with whether specified or
tot. The permit does not give authuritto violate the provisions of any other state or local law regulation construction or the performance of construction.
'roperty Owners Name^ Susan Walsh Phone Number 904-742-5586
Vlechanical Company__• AC DESIGNS INC Office Phone 904-829-8898 Fax904-829-6587
767A—ddress: 3370 AGRICULTURAL CENTER DR City ST AUGUSTINE State FL Zip 32092
License Holder(Print): _F,DWARD NN T State Certification/Registration#CAC1813372
Votarized Signature of License Holder Zi
r
Before me this day of n, 20 ZL)
,, ;°ii'• GUY D.PRICE I
I
? : Notary Public•State of Honda Signature of Notary Public !__
Ls Commission 0 GG 333956
1 -f- 7 My Comm.Expires Sep.5.2023
9onded through National Notary Assn.
,s _ sJ Cash Register Receipt Receipt Number
og p
r City of Atlantic Beach R11571
DESCRIPTION I ACCOUNT QTY PAID
PermitTRAK $107.00
ACRS20-0027 Address: 83 NICOLE LN APN: 169519 0825 $107.00
MECHANICAL $103.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
AC AND REFRIGERATION 455-0000-322-1000 3 $24.00
FURNACES AND HEATING 455-0000-322-1000 34200 $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: R11571 $107.00
Date Paid: Tuesday, January 28, 2020
Paid By: A/C DESIGNS OF ST AUGUSTINE
Cashier: CT
Pay Method: CREDIT CARD 3
Printed:Tuesday,January 28,2020 9:50 AM 1 of 1