341 6th St GSRS20-0006 Stove .,,' ,',v,�' MECHANICAL RESIDENTIALPERMIT GAS PERMIT NUMBER
_�
\ " ISSUED: 2/19/2020
\. osis/ CITY OF ATLANTIC BEACH EXPIRES: 8/17/2020
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 GAS-PIPING TO
341 6TH ST MECHANICAL RESIDENTIAL GAS STOVE FOR KITCHEN $600.00
REMODEL
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
169897 0000 ATLANTIC BEACH
COMPANY: ADDRESS: CITY: STATE: ZIP:
AA BOTTLED GAS
COMPANY INC 12601 N MAIN ST JACKSONVILLE FL 32218
OWNER: ADDRESS: CITY: STATE: ZIP:
LUCAS JAMES M 341 6TH ST ATLANTIC BEACH FL 32233-5347
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
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
GAS PIPING OUTLETS 455-0000-322-1000 1 $10.00
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: 2/19/2020 1 of 2
‘,,,S'v'''',,, MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
� ''' GSRS20-0006
PERMIT
/ ISSUED: 2/19/2020
CITY OF ATLANTIC BEACH EXPIRES: 8/17/2020
TOTAL:$69.00
Issued Date:2/19/2020 2 of 2
;s==L-!i,,;. Mechanical Permit Application **ALL INFORMATION
7r HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 n
��`°'f"l Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: O S►`S` 0-`CO0co
JOB ADDRESS: 2 Lt 1 Low S'cy'eC'k" PROJECT VALUE$ f)00.(:°
❑NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI#(REQUIRED)
El Air Handling Equipment Only El Condenser Only El Air Handling Unit& Condenser
Air Conditioning: Unit Quantity Tons per Unit
Heat: Unit Quantity BTUs per Unit Seer Rating(REQUIRED)
Duct Systems: Total CFM
nREPLACEMENT AIR CONDITIONING& HEATING SYSTEM INSTALLATION ARI#(REQUIRED)
®Air Handling Equipment Only El Condenser Only El 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
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
''y, ALL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets _I_ Pumps
#Vented Wall Furnaces Refrigerator Condenser BTUs
#Water Heaters Solar Collection Systems
Tanks (gallons)
Wells
MOTHER: ye Q-- ',v r' SAS 14)e_ G.hc 4Zv.r\ •• '\Y1Q.. kr.) SA-0,�
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: bill v `• — .46' an' .Viie A L.U(CkS Phone Number: c'1G`-\- -1t- IC1-2-1-
Mechanical Company: -F\\? t'\EC\ C10\S Cc), Office Phone: clOS4- 51- l\2_14 Fax
Co.Address: \12-( ()\ 3cW ', bM).,\V\ -FY'e - City: ' G1X. State: E-L-Zip: . 22-1F
License Holder:___DCa\)1 ND Pi r\1LS tate Certification/Registration At 01S2.0
Notarized Signature of License Holder o
l
The foregoing instrument was acknowledged before me this )7�d � '�:a of � t� L , 0G-c/ the State of Florida,
County of ' ' i k AL.. / Amin
Signature of Notary Public /�' rktfoffigrila4
,...01 , Notary Public State of Florida [ ersonally Known OR[ ] • educed Identification
7• Mist W Wooten-Klemmedson Type of Identification:
V .
t My Commission GG 339151
Expires 05/25a023 Updated 10/9/18
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Jf Cash Re ister Recei t Receipt Number
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City of Atlantic Beach R11769
DESCRIPTION I ACCOUNT I QTY I PAID
PermitTRAK $69.00
GSRS20-0006 Address: 341 6TH ST APN: 169897 0000 $69.00
MECHANICAL $65.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
GAS PIPING OUTLETS 455-0000-322-1000 1 $10.00
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: R11769 $69.00
Date Paid: Wednesday, February 19, 2020
Paid By: AA BOTTLED GAS COMPANY INC
Cashier: FJ
Pay Method: CREDIT CARD 6
Printed:Wednesday, February 19, 2020 9:38 AM 1 of 1j