1242 Beach Ave GSRS20-0091 Permit PacketOWNER:ADDRESS:CITY:STATE:ZIP:
KING JOHN ANTHONY 1242 BEACH AVE ATLANTIC BEACH FL 32233
COMPANY:ADDRESS:CITY:STATE:ZIP:
Blossman Gas, Inc 5923 Soutel Drive Jacksonville Fl 32219
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
171828 0000 MANDALAY
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
1242 BEACH AVE MECHANICAL RESIDENTIAL GAS 2 gas-piping outlets & water
heater for interior remodel $600.00
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
GAS PIPING OUTLETS 455-0000-322-1000 2 $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
VENTED WALL FURNACE WATER HEATER UNIT 455-0000-322-1000 1 $5.00
TOTAL: $74.00
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
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.
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.
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.
1 of 2Issued Date: 12/8/2020
PERMIT NUMBER
GSRS20-0091
ISSUED: 12/8/2020
EXPIRES: 6/6/2021
MECHANICAL RESIDENTIAL GAS
PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
2 of 2Issued Date: 12/8/2020
PERMIT NUMBER
GSRS20-0091
ISSUED: 12/8/2020
EXPIRES: 6/6/2021
MECHANICAL RESIDENTIAL GAS
PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $74.00
GSRS20-0091 Address: 1242 BEACH AVE APN: 171828 0000 $74.00
MECHANICAL $70.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
GAS PIPING OUTLETS 455-0000-322-1000 2 $10.00
VENTED WALL FURNACE WATER HEATER
UNIT 455-0000-322-1000 1 $5.00
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: R14316 $74.00
Printed: Tuesday, December 8, 2020 1:48 PM
Date Paid: Tuesday, December 08, 2020
Paid By: Blossman Gas, Inc
Pay Method: CREDIT CARD 402065951
1 of 1
Cashier: CG
Cash Register Receipt
City of Atlantic Beach
Receipt Number
R14316