330 2ND ST - HVAC ,,, „,iii
..,_,..„
0_ ii.._ - ,s, CITY OF ATLANTIC BEACH
„'' t
;s:'; 800 SEMINOLE ROAD
Jv ATLANTIC BEACH, FL 32233
1'4011 >. INSPECTION PHONE LINE 247-5814
MECHANICAL RESIDENTIAL HVAC -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: ACRS17-0264
Description: HVAC - 1 A/C, 1 AHU, 3.5 TON
Estimated Value: 0
Issue Date: 12/20/2017
Expiration Date: 6/18/2018
PROPERTY ADDRESS:
Address: 330 2ND ST
RE Number: 169761 0075
PROPERTY OWNER:
Name: MORELAND COLSEY B
Address: 330 2ND ST
ATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name:
Address:
Phone:
PERMIT INFORMATION:
Please see attached conditions of approval.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOU 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.
* A notice of Commencement is only required for work exceeding an estimated value of
$2,500. For HVAC work, a Notice of Commencement is only required when HVAC work
exceeds and estimated value of$7,500.
MECHANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph(904)247-5826 Fax(904)247-5845 re.RS 17 - b z‘, 4
JOB ADDRESS:33 O 2 KS. S` rt_CE-
PROJECTYAZ U.�' �o � � c., � r
PERMTT#
�-- ARI# t (. REQUIRED
Air Handling Equipment Only . ...Air Handling Unit & Condenser
Condenser Only
NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION
AConditioUnit
Aieat:rir . Unit Quantity .- Tons Per Unit 1
Heat Systems: Tett Quantity
a ty BTU's Per Unit Seer Rating_____4-f
FM
REPLACEMENT AHI CONDI'T'IONING & HEATING SYREQ17IRED
Air Conditioning: Unit Quantityi STEM ZNSTALLATXON
Heat: Tons Per Unit �,j
Heat Systems: t Quantity
- _-- BTU's Per Unit o C: Seer Rating t
FIRE PREVENTION REQ IRLD
Fire Sprinkler System Quantity
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)
Comlxlerciai Hoods Quantity (Requires
(Requires 3 sets of plans)
Fire Suppression Systems Quantity - (Requires 33
sets of plans)
(Requires 3 sets of plans)
FIRE PLACES MISCELLANEOUS:
Prefabricated Fireplace Qty
Cris Piping Outlets Automobile Lifts
Boilers BTU's
ALL OTHER GAS PIPING Elevators/Escala ours �`
Quantity of Outlets Heat Exchanger
#Vented Wall Furnaces Pumps
# Water Heaters Refixgerator Condenser BTU's
Solar Collection Systems
Tanks (gallons)
Wells
OTHER:
Permit he comes 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
:his:app lication 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
,ot. The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of construction.
'roperty Owners Name S u2 Phone Number ?O /_ 6 d 2.--?1,‘vlechanical Company ao qi,1/41 t-i.E.,* S 6-c_
Office Phone 2/-/-37 Fax
2-z_21-.-11_71-_s
-o. Address: 3 l 5— 6 t('` bid-C S
�icense Holder(Print): W i i o O� City" 'T (.3c State i--7 Zip 2. Z
Voicr�(zYState Certification/Registration# ��Ca��( 76 (' '.�{• ;� plisiwoJder As .
4 ;'4 '.**1 Commission i 119685
r
�lr�w .19
1 t,.e.eaaB.efS, mell; 't day of c+�wt 20 /
ignature of Notary Public 11 . i...,._•, h. •
1
's04 ; Cash Register Receipt Receipt Number
City of Atlantic Beach R3743
r1 J
DESCRIPTION I ACCOUNT I QTY PAID
PermitTRAK $206.00
ACRS17-0264 Address: 330 2ND ST APN: 169761 0075 $107.00
MECHANICAL $103.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
AC AND REFRIGERATION 455-0000-322-1000 4 $24.00
FURNACES AND HEATING 455-0000-322-1000 1 $24.00
STATE SURCHARGES $4.00
STATE DBPR SURCHARGE 455-0000-208-0600 0 $2.00
STATE DCA SURCHARGE 45500002080700 0 $2.00
ACRS17-0265 Address: 885 SEMINOLE RD APN: 170026 0000 $99.00
MECHANICAL $95.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
AC AND REFRIGERATION 455-0000-322-1000 3 $16.00
FURNACES AND HEATING 455-0000-322-1000 1 $24.00
STATE SURCHARGES $4.00
STATE DBPR SURCHARGE 455-0000-208-0600 0 $2.00
STATE DCA SURCHARGE 45500002080700 0 $2.00
TOTAL FEES PAID BY RECEIPT: R3743 $206.00
_ r- CJ r` N — .>: 00 M
v0 . W a. 8 ,, �p
i— vs O
CJ N ?x�
W
- X CD
m ce
. xXX
U J L Pe OV
Z Z Q c..) Q
g W m .D 4 .Lii
D [n O
a tjj v S
O o z z
r vv -- O• _
v C
_ it St cp O U . . T
_Lpp
-N-.l V W m Z W F— V V1
Date Paid: Wednesday, December 20, 2017
Paid By: DONOVAN HEATING & AIR
Cashier: BA
Pay Method: CREDIT CARD 2
Printed:Wednesday, December 20,2017 11:47 AM 1 of 1 III
TRW(