1805 ATLANTIC BEACH DR - GSRS20-0011 4/7.1.1.J-V1-1.2„, MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
PERMIT GSRS20-0011
CITY OF ATLANTIC BEACH ISSUED: 3/11/2020EXPIRES: 9/7/2020
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:
1805 ATLANTIC BEACH DR MECHANICAL RESIDENTIAL GAS GAS PIPING - ONE GRILL $590.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
169505 1505 ATLANTIC BEACH
COUNTRY CLUB UNIT 02
COMPANY: ADDRESS: CITY: STATE: ZIP:
PROGASCO, CORP. 7709 ALTON AVE JACKSONVILLE FL 32211
OWNER: i ADDRESS: j CITY: I STATE: ZIP:
KROUCH WILLIAM T TRUST 1805 ATLANTIC BEACH DR 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
TOTAL:$69.00
Issued Date:3/11/2020 1 of 2
`*ALL INFORMATION
: : Y, IVlechanical Permit Application HIGHLIGHTED IN
I'`f +T+�'r.. GRAY IS REQUIRED.
,
lid: 1 City of Atlantic Beach Building Department DIRE .lc i -
Irlt N 800 Seminole Rd, Atlantic Beach, FL 32233 (---- S RS ZC)- Cao (
' ``'"• Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:
�� PROJECT VALUE $ i'f' `ff
JOB )DRES` : � 'v> A-1/671/2c lJt'Ctc/1 f ,iv"f'
E_I f, i N AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI#(REQUIRED)
I Air He idling Equipment Only ❑ Condenser Only ® Air Handling Unit& Condenser
,=k.r Condit,oning: Unit Quantity Tons per Unit
.,it: Unit Quantity BTUs per Unit Seer Rating (REQUIRED)
: :t Syste ms: Total CFM
[ IPAILACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION AR!# (REQUIRED)
A]Air Handling Equipment Only 0 Condenser Only ❑Air Handling Unit& Condenser
t, r Conditioning: Unit Quantity Tons per Unit
..3t: Unit Quantity BTU's Per Unit Seer Rating (REQUIRED)
_: , :t Syste ns: Total CFM
OFIRE PREVENTION
Fire Sprinkler System Quantity (Requires 3 sets of plans)
Fire Standaipe Quantity (Requires 3 sets of plans)
U -derground Fire Main Value (Requires 3 sets of plans)
Fi-e Hose Cabinets Quantity (Requires 3 sets of plans)
Commercial Hoods Quantity (Requires 3 sets of plans)
i.e Suppression Systems Quantity (Requires 3 sets of plans)
0FIRE PLACES n MISCELLANEOUS:
Piefabrica:ed Fireplace (Qty) Automobile Lifts
C 3:, Piping Outlets Boilers BTUs
Elevators/Escalators
_ALL OTHER GAS PIPING Heat Exchanger
Q..antity of Outlets / Pumps
± Vented Wall Furnaces Refrigerator Condenser BTUs
== .'later Heaters Solar Collection Systems ,_
Tanks (gallons)
Wells
OTHER: .FX-kith% (-16 ii' L/)4'r' l l
+'ernr becomes void if work does not commence within 2 six month period or work is suspended or abandoned for six months. I hereby
ar:i';tiat I have read this application and know the same to be true and correct. All provisions of laws and ordinances governing this
c-4 will be complied with whether specified or not. The permit does not give authority to violate the provisions of any other state or
._a ;w regulation construction or the performance of construction.
f .
r:)Gn r er Name ';ii! c:r"Z tl CSI Phone Number('''''''' `.' ` r .- �
<a4/3
r c 7,1 �V31 Fax 771. 5731
Mechanical Company: ":��(' Office Phone:''<l��I)
.:o. ,\ddress: _77(4 1417i-I p /-h 1.ilie City: c t'te..i.e_;4'-'d,7 I.,'iVf State: IL Zip: .-??"41/l
tticense Holder: /0-eivii i LclCi i) )6) State Certification/Registration 4 (7 7c1
laottn ized Signature of License Holder / _' tom" ,
/�—liday of (i �3202-0 in the State of Florida,
"h.: f�>regoin;; instrument was acknowledged before me this , ---�
.1 y of 171 .v a I �.LA-4-
pi
Signature of Notary Public/Jt9 ILQ-t,t.-<<--4u
�x µotary Pubic Sate of Flonda [ rsonally Known OR [ J Produced Identification
Stephanie Renee McGuire
;1; p< My Commission GG 123258 Type of Identification: Updated 10/9/18
cy.:F Expos 0e10t12021
-40:41101%
Cash Register Receipt Receipt Number
JCity of Atlantic Beach R11968
01119
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $69.00
GSRS20-0011 Address: 1805 ATLANTIC BEACH DR APN: 169505 1505 $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: R11968 $69.00
Date Paid: Wednesday, March 11, 2020
Paid By: PROGASCO, CORP.
Cashier: FJ
Pay Method: CREDIT CARD 10
Printed:Wednesday, March 11,2020 4:39 PM 1 of 1