315 PLAZA - ACRS20-0314 iI M0echanicalSeminole Permittlantic ApplicationBeach, FL32233 **ALL INFORMATION
�� . HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
; 80Rd, A ((�� 7 z /I
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: PkiaSZc�-0314
JOB ADDRESS: o S Mo.La- PROJECT VALUE $ 3 7 (// , a'i
NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION AR!#(REQUIRED)
❑ Air Handling Equipment Only ❑ 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)
❑ Air Handling Equipment Only ❑ Condenser Only t/Air Handling Unit& Condenser
Air Conditioning: Unit Quantity / Tons per Unit l' C
Heat: Unit Quantity BTU's Per Unit 3i) J''d Seer Rating (REQUIRED) 7y
Duct Systems: Total CFM
I '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
ALL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets Pumps
#Vented Wall Furnaces Refrigerator Condenser BTUs
#Water Heaters Solar Collection Systems
Tanks (gallons)
Wells
I BOTHER:
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: dlr.+ Ill ijrt� Phone Number: cg5u-2911- (//
Mechanical Company: 8- c.,04\ o4r c,r,1t'4t+hn1 ahl 14t°,41 t" - Office Phone: 375-970 Fax37s-1 1
Co. Address: 1833 1,1 A~Lii Ovl S`lt" tat City: O? State: a Zip: 3706S
License Holder: Mora-1+ geo•vin y State Certification/Registration# CAG/87_7865
iV,i, - (--
Notarized Signature of License Holder /
The foregilift, strument was acknowledged before me thisl� day 20zOn the State of Florida,
County of Oftel ---
Signature of Notary Pub J Q 4111k-c_
'riv, TONIGINOLESPERGER
, [ ] Personally Known OR [ ] Produced Identification
,,s_i_ MY COMMISSION#GG 353178
=•: ;,; Type of Identification: L.
''.I EXPIRES:October 6,2023 Yp
''•.Fo'di'$P. Bonded Thru Notary Public Underwriters Updated 10/9/18