115 Seminole Rd ACRS20-0057 1:tp,„; MECHANICAL RESIDENTIAL HVAC PERMIT NUMBER
PERMIT ACRS20-0057
ISSUED: 2/24/2020
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CITY OF ATLANTIC BEACH EXPIRES: 8/22/2020
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:
115 SEMINOLE RD MECHANICAL RESIDENTIAL HVAC- 1 A/C, 1 AHU, 3 TON $7662.00
HVAC
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
170611 0100 SALTAIR SEC 01
COMPANY: ADDRESS: CITY: STATE: ZIP:
COOL R US 6900 PHILIPS HWY SUITE 46 JACKSONVILLE FL 32216
OWNER: ADDRESS: CITY: STATE: ZIP:
DELORETO KAREN H 115 SEMINOLE RD ATLANTIC BEACH FL 32233
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
AC AND REFRIGERATION 455-0000-322-1000 3 $24.00
FURNACES AND HEATING 455-0000-322-1000 36000 $24.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
I STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $107.00
Issued Date: 2/24/2020 1 of 2
MECHANICAL RESIDENTIAL HVAC
?i PERMIT NUMBER
s
• PERMIT 41111,
ACRS20-0057
''` ISSUED: 2/24/2020
�' CITY OF ATLANTIC BEACH EXPIRES: 8/22/2020
Issued Date: 2/24/2020 2 of 2
Iviecnanicai hermit Application PILL
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HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233
Pse-RS Z0 O S�
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:
JOB ADDRESS: 115 Seminole RdAtlantic Beach, FL 32233 PROJECT VALUE $7,662.00
❑NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION AR!#(REQUIRED)
❑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
[REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI#(REQUIRED) 7599443
❑Air Handling Equipment Only 0 Condenser Only 0 Air Handling Unit& Condenser
Air Conditioning: Unit Quantity 1 Tons per Unit 3.0
Heat: Unit Quantity 1 BTU's Per Unit 36,000 Seer Rating (REQUIRED) 17.00
Duct Systems: Total CFM
Fl 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)
nFIRE PLACES r--1 MISCELLANEOUS:
Prefabricated Fireplace (Qty) Automobile Lifts
Gas Piping Outlets Boilers BTUs
Elevators/Escalators
❑ALL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets Pumps
# 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:Karen Deloreto Phone Number: (352)942-9413
Mechanical Company: Cool R Us,lnc Office Phone: (904)281-2108 Fax
Co. Address: 3006 Mercury Rd S City: Jacksonville State: Fl Zip: 32207
License Holder: Lek Gjoka ate Certification/Registration# CAC1815614
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Notarized Signature of License Holder " l 1. �[ l
The foregoing instrument was acknowledged before me this C ay of r ,Mac in the State of Florida,
County of DA,-1 r
Signature of Notary Public ,Q(�� o
DAMIANTYLER FERGUSON [ ) Personally Known OR ['4 Produced Identification
•_... Notary Public-State of Florida
' = F�• ::�•.,.�, �,; Commission GG 228958 Type of Identification: l
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My Comm.Expires Jun 14, 2022 Updated 10/9/18
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a Cash Register Receipt Receipt Number
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City of Atlantic Beach R11811
DESCRIPTION I ACCOUNT QTY PAID
PermitTRAK $107.00
ACRS20-0057 Address: 115 SEMINOLE RD APN: 170611 0100 $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 36000 $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: R11811 $107.00
Date Paid: Monday, February 24, 2020
Paid By: COOL R US
Cashier: FJ
Pay Method: CREDIT CARD 9
Printed: Monday, February 24,2020 3:10 PM 1 of 1