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1830 Seminole Rd GSRS20-0007 2 Tanks MECHANICAL RESIDENTIAL GAS PERMIT NUMBER �... PERMIT GSRS20-0007 ISSUED: 3/6/2020 CITY OF ATLANTIC BEACH EXPIRES: 9/2/2020 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: 1830 SEMINOLE RD MECHANICAL RESIDENTIAL GAS GAS PIPING 2 100 Ib $699.00 TANKS AND ONE OUTLET TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION: CONSTRUCTION: NUMBER: GROUP: 172020 0510 SELVA MARINA UNIT 09 COMPANY: ADDRESS: CITY: STATE: , ZIP: D & D Gas, Inc. 7709 Alton Ave Jacksonville FL 32211 OWNER: ADDRESS: CITY: STATE: ZIP: ANDREW BRYANT 1830 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. 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 TANKS GAS OR LIQUEFIED PETROLEUM 455-0000-322-1000 150 $20.00 TOTAL: $89.00 Issued Date: 3/6/2020 1 of 2 r0--'"i`y, MECHANICAL RESIDENTIAL GAS PERMIT NUMBER j y L s PERMIT iiiGSRS20-0007 �v -" ISSUED: 3/6/2020 ,r,; ,, CITY OF ATLANTIC BEACH EXPIRES: 9/2/2020 Issued Date: 3/6/2020 2 of 2 Mechanical Permit Application '-,w '. , �HTEDN.TION City of Atlantic Beach Budding Department Air a' "'REQUIRED. 800 Seminole Rd, Atlantic Beach, FL 32233 as lSZO -0007 �A°i!'', Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT*: JOB ADDRESS: [ 6 3 0 SCSI. matt ,RAWAW. PROJECT VALUE$ ', f' ' 0 C ❑NEW AIR CONDITIONING &HEATING SYSTEM INSTALLATION ARI#(REQUIRED) ©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 DREPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI#(REQUIRED) o Air Handling Equipment Only D 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 0MISCELLANEOUS: Prefabricated Fireplace (Qty) Automobile Lifts Gas Piping Outlets Boilers BTUs Elevators/Escalators EAU.OTHER GAS PIPING Heat Exchanger Quantity of Outlets ____I___ Pumps #Vented Wall Furnaces Refrigerator Condenser BTUs #:Water Heaters Solar Collection Systems Tanks (gallons) - o (5Z2j&() Wells •OTHER: Li ii +-v ran't ' se+ O ve. rvvnd ICAs -+ LLD EN.nc_ 1- Permit 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. '`�;' i 3 ''` f� Phone Number: 14' 6 —/7 3'7 Owner Name:. �.��- ;�``�;_ +r'.�� `�n °�'x '. i"��`,. ,�`. Mechanical Company: # `` `' 1 Office Phone:MAPA44404tV,Fax 7;-/-573V4 ., 3 §�-�: City �� :. .3Z2- Co.Address: � � ����►i3' E ,`` , � ro� ,.�f� � State Zip. License Holder: . . e n^ a -44 Via.. =t K - State Certification/Registration#At, liti44)9. Notarized Signature of Licenses'.er if.X' "re.'V 1.- . �,,.. .. ` $ d�- s",1,- r i�,�.��/i�-� s�'r��,>�s...,:,� The foregoing instrumgnt was acknowledged before me this J ay of ka kili , 202 in the State of Florida, I County of viA,I'a 1 1644... - i�G "' Signature of Notary Public�� ,P N Notary Public State of Honda ., Slephi3nie Renee AAcGuire [( rsoinally Known OR[ I Produced Identification My Commission GG 123258 aadr' Expires 0610 112 0 2 1 Type of Identification: Updated 10/9/18 rf ij J Cash Register Receipt Receipt Number City of Atlantic Beach R11920 DESCRIPTION ACCOUNT I QTY I PAID PermitTRAK $89.00 GSRS20-0007 Address: 1830 SEMINOLE RD APN: 172020 0510 $89.00 MECHANICAL $85.00 MECHANICAL BASE FEE I 455-0000-322-1000 0 $55.00 GAS PIPING OUTLETS 455-0000-322-1000 1 $10.00 TANKS GAS OR LIQUEFIED PETROLEUM 455-0000-322-1000 150 $20.00 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: R11920 $89.00 Date Paid: Friday, March 06, 2020 Paid By: D & D Gas, Inc. Cashier: FJ Pay Method: CREDIT CARD 2 Printed: Friday, March 06,2020 9:39 AM 1 of 1