1771 MARITIME OAK DR - GSRS20-0003 Li- MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
GSRS20-0003
75110 -. PERMIT ISSUED: 2/10/2020
�o:3„/ CITY OF ATLANTIC BEACH EXPIRES: 8/8/2020
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:
INSTALL 5 GAS-PIPING
1771 MARITIME OAK DR MECHANICAL RESIDENTIAL GAS OUTLETS FOR NEW SINGLE $2400.00
FAMILY HOME
TYPE OF i REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: I NUMBER: GROUP:
169505 1815 ATLANTIC BEACH
COUNTRY CLUB UNIT 02
COMPANY: I ADDRESS: CITY: STATE: i ZIP:
OWNER: I ADDRESS: CITY: STATE: ZIP:
GROH JAMES S 1550 AVONDALE AVE JACKSONVILLE FL 32205
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
GAS PIPING OUTLETS 455-0000-322-1000 5 $12.00
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
TOTAL:$71.00
Issued Date: 2/10/2020 1 of 2
Mechanical Permit Application **ALL INFORMATION
.1t4 , pp HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 �y�
�q •
t Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: �Se-Sa 0-6003
JOB ADDRESS: 1771 MARITIME OAK DRIVE,ATLANTIC BCH,FL 32233 PROJECT VALUE $2,400.00
❑NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI#(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
EREPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION AR/#(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
El 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 ElMISCELLANEOUS:
Prefabricated Fireplace (Qty) Automobile Lifts
Gas Piping Outlets 1 Boilers BTUs
Elevators/Escalators
EIALL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets 3 Pumps
#Vented Wall Furnaces Refrigerator Condenser BTUs
#Water Heaters 1 Solar Collection Systems
Tanks (gallons)
Wells
Q OTHER: Gas piping to Tankless Water Heater,Cook Top, Fireplace,Dryer Stub,& Grill Stub
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:Glenn Layton Homes Phone Number: (904)476-6487
Mechanical Company: AEI GAS SERVICES Office Phone: (904)724-9771 Fax(904)721-3350
Co.Address: 7709 ALTON AVENUE City: JACKSONVILLE State: FL Zip: 32211
License Holder: BELINDA SPRADLIN State Certification/Registration# 9917
Notarized Signature of License Holder / 141--1/c___ /A--z-
The foregoin instrument was acknowledged before me this,)(,oda of\ T)cOUJ- 20J 'n the tate of Florida,
County of Q, J „.._l_
Signature of Notary Pub cd --k,l3i,4k_ �'
,,,,rt►yc Notary Public State of Florida [`personally Known OR [ I Produced Identification
Stephanie E Carter
My Comm�a�ion cc 2s 42s Type of Identification:
4M1r Expees 07/18i2J22 Updated 10/9/18
rt L`i,rin
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�r.:✓r Cash Register Receipt Receipt Number
v `~ City of Atlantic Beach R11692
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DESCRIPTION ACCOUNT I QTY I PAID
PermitTRAK $71.00
GSRS20-0003 Address: 1771 MARITIME OAK DR APN: 169505 1815 $71.00
MECHANICAL $67.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
GAS PIPING OUTLETS 455-0000-322-1000 5 $12.00
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: R11692 $71.00
Date Paid: Monday, February 10, 2020
Paid By: GROH JAMES S
Cashier: CT
Pay Method: CREDIT CARD 3
Printed: Monday, February 10,2020 2:55 PM
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