2377 Seminole Rd ACRS20-0040 HVAC permit .ri '% MECHANICAL RESIDENTIAL HVAC PERMIT NUMBER
PERMIT R M I T ACRS20-0040
ISSUED: 2/13/2020
;i9r CITY OF ATLANTIC BEACH EXPIRES: 8/11/2020
MUST CALL INSPECTION PHONE • 1 . 247-5814 BY . PM FOR . INSPECTION.
ALL • ' CONFORM • THE CURRENT • 1 OF • ' D+ BUILDING
CODE, AND OF ATLANTIC , CH CODE OF ORDINANCES .
ALL • i OF PERMIT APPLY, • + + 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 UNIT F ,HVAC - 1 A/C, 1
2377 SEMINOLE RD $4978.00
HVAC AHU, 2.5 TON
OF +
• • GROUP:
168908 8505 SAND DOLLARS
COMPANY: ADDRESS: CITY: STATE: ZIP:
POLAR AIR & HEAT INC P.O. BOX 77177 JACKSONVILLE FL 32218
OWNER:
ADDRESS: CITY: STATE: ZIP:
SAND DOLLAR SANCTUARY 3500 RICHMOND ST JACKSONVILLE FL 32205-9422
LLC
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 • . •
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 3.5 $24.00
FURNACES AND HEATING 455-0000-322-1000 42000 $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: 2/13/2020 1 of 2
MECHANICAL RESIDENTIAL HVAC PERMIT NUMBER
ACRS20-0040
PERMIT
ISSUED: 2/13/2020
CITY OF ATLANTIC BEACH EXPIRES: 8/11/2020
TOTAL:$107.00
Issued Date:2/13/2020 2 of 2
Mechanical Permit Application "ALL INFORMATION
HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233fa 11- — QcA C
Phone: (904) 247-SR26 Email: 5uildinj-ue2t@coab.us PERMIT#:
JOB ADDRESS; 2377 SEMINOLE- RD UNIT F,ATLANTIC BCF{ FL PROJECT VALUE $4978
❑NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI#(REQUIRED)
❑Air Hondling Equipment Only O 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
REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI#(REQUIRED) 7995441
❑Air Handling Equipment Only ❑Condenser Only VAir Handling Unit& Condenser
Air Conditioning: Unit Quantity I Tons per Unit 3 5
Heat: Unit Quantity I01<LN I BTU's Per Unit Seer Rating (REQUIRED) 14
Duct Systems: Total CFM 1400
❑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 BTUs
Elevators/Escalators
❑Alt OTHER GAS PIPING Heat Exchanger
Quantity of Outlets Pumps
$$Vented Wall Furnaces Refrigerator Condenser BTUs
Water Heaters Solar Collection Systems
Tanks (gallons)
Wells
MOTHER:
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.
( � 944-6 t 4.2660
Owner Name: SCOTT DOOLITTLE / S�Xo_ 'D cp I r` �C'_�r�, hone Number:
Mechanical Company: POLAR AIR a HEAT.INC, Office Phone$ 4596-1004 FaxNrn
Co.Address: P O.13OX 77177 City: JACKSONVILLE State: FL Zip; 32226
License Holder: ANTHONY ROKASY State Certification/Registration# CAC057673
Notarized Signature of License Holder
The foregoi instrument was acknowledged before me this f� day _F�' , 20&, in the State of Florida,
County of VU,UA,I
Signature of Notary Public
:KFCAARS
Cu3
ersonally Known OR[ ) Produced Identification
Cww#ssi3m? Type of Identification:
My Corm.E 13.2021
Updated IOJ'J/I8
60,Ord dxarMry kw
J Cash •
BeachCity of Atlantic
R11720
DESCRIPTION ACC• QTY PAID
PermitTRAK $107.00
ACRS20-0040 Address: 2377 SEMINOLE RD APN: 168908 8505 $107.00
MECHANICAL $103.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
AC AND REFRIGERATION 455-0000-322-1000 4 $24.00
FURNACES AND HEATING 455-0000-322-1000 42000 $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
TOTAL1 $107.00
Date Paid: Thursday, February 13, 2020
Paid By: POLAR AIR & HEAT INC
Cashier: FJ
Pay Method: CREDIT CARD 2
Printed:Thursday, February 13, 2020 9:10 AM 1 of 1