1619 BEACH AVE - MCRS20-0003 s?
L4'4' MECHANICAL RESIDENTIAL OTHER PERMIT NUMBER
PERMIT
MCRS20-0003
t)v- z ISSUED: 3/3/2020
I ,a CITY OF ATLANTIC BEACH EXPIRES: 8/30/2020
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:
1619 BEACH AVE MECHANICAL RESIDENTIAL EXAUST HOOD $0.00
OTHER
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
169648 0000 NORTH ATLANTIC BCH
UNIT 1
COMPANY: ADDRESS: CITY: STATE: ZIP:
HAMMOND AIR
CONDITIONING INC 3412 GALILEE RD JACKSONVILLE FL 32207
OWNER: ADDRESS: CITY: STATE: ZIP:
MOODY DOUGLAS W 1619 BEACH AVE 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
AIR DUCT SYSTEM 455-0000-322-1000 1 $20.00
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:3/3/2020 1 of 2
Mechanical Permit Application **ALL INFORMATION
HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 i\lke RSZC 000 =-
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:
JOB ADDRESS: 1619 BEACH AVE., ATLANTIC BEACH, FL 32233 PROJECT VALUE $
E NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION AR!#(REQUIRED)
0 Air Handling Equipment Only 0 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
❑REPLACEMENT 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
^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 n MISCELLANEOUS:
Prefabricated Fireplace (Qty) Automobile Lifts
Gas Piping Outlets Boilers BTUs
Elevators/Escalators
f]ALL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets Pumps
# Vented Wall Furnaces Refrigerator Condenser BTUs
# Water Heaters Solar Collection Systems
Tanks (gallons)
Wells
p OTHER: EXHAUST HOOD REPLACEMENT (BUILDER PERMIT#RES19-0332)
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:DOUGLAS MOODY Phone Number: (904)874-7395
Mechanical Company: HAMMOND AIR CONDITIONING Office Phone: (904)398-0488 Fax
Co. Address: 3412 GALILEE ROAD City: JACKSONVILLE State: FL Zip: 32207
License Holder: BRANDON HAMMOND State Certification/Registration # CAC1816450
Notarized Signature of License Holder —51/27, ell
The foregoing instrument was acknowledged before me this 3'-re day of Marcy. , 2011-), in the State of Florida,
County of lu VA-2—
0vrto� NANCY JANE DEMPSEY Signature of Notary Public
V
+p Commission#GG 301072
,n7' Expires Fobuary 12.2023 [�rsonally Known OR [ ] Produced Identification
V. tet`,?° g�xd.AltwubwM3atN�rtuySor'Iw"' Type of Identification:
Updated 10/9/18
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Cash Register Receipt Receipt Number
City of Atlantic Beach R11887
DESCRIPTION I ACCOUNT QTY PAID
PermitTRAK $79.00
MCRS20-0003 Address: 1619 BEACH AVE APN: 169648 0000 $79.00
MECHANICAL $75.00
AIR DUCT SYSTEM 455-0000-322-1000 1 $20.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
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: R11887 $79.00
Date Paid: Tuesday, March 03, 2020
Paid By: HAMMOND AIR CONDITIONING INC
Cashier: CT
Pay Method: CREDIT CARD 7
Printed:Tuesday, March 03, 2020 3:14 PM 1 of 1 j