550 Sherry Dr GSRS21-0001 Range, Grill 51-i v"' MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
PERMIT GSRS21-0001
,n- ISSUED: 1/6/2021
x �;; ,; CITY OF ATLANTIC BEACH EXPIRES: 7/5/2021
MUST CALL INSPECTION PHONE UNE (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:
550 SHERRY DR MECHANICAL RESIDENTIAL GAS GAS PIPING - RANGE & GRILL $600.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
170465 0010 SALTAIR SEC 03
COMPANY: ADDRESS: CITY: STATE: ZIP:
Hall's Gas Services, Inc. 3047 St Johns Bluff Rd S#8 Jacksonville FL 32246
OWNER: ADDRESS: CITY: STATE: ZIP:
BRIESEMEISTER NATHAN 465 BEACH AVE ATLANTIC BEACH FL 32233
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT Il
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.
illiiiitiminiiiiiiii-. 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 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
TOTAL:$69.00
Issued Date: 1/6/2021 1 of 2
MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
GSRS21-0001
S". �,. . PERMIT
ISSUED: 1/6/2021
CITY OF ATLANTIC BEACH EXPIRES: 7/5/2021
Issued Date: 1/6/2021 2 of 2
Mechanical Permit Application **ALL INFORMATION
,SQL iv �� HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
Eil
'�! '' " 800 Seminole Rd, Atlantic Beach, FL 32233 cS ksz ( _L()CD (
`tnf 0- Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:
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JOB ADDRESS: '- -SL'. eJ1-(n- PROJECT VALUE $ CU 00 ----
NEW
'NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI#(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
I I REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI#(REQUIRED)
❑ Air Handling Equipment Only ❑ Condenser Only ❑ 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
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)
AFIRE PLACES MISCELLANEOUS:
Prefabricated Fireplace (Qty) Automobile Lifts
Gas Piping Outlets Boilers BTUs
Elevators/Escalators
[MALL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets Pumps
#Vented Wall Furnaces Refrigerator Condenser BTUs
#Water Heaters Solar Collection Systems
Tanks (gallons)
� Wells
(OTHER: 6-'7S P•, -fo— A, .-„„J ‘c:i/
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: 4./eiJ/--- Phone Number: >>0- 9b- 9776&
Mechanical Company: 1rs (,..s.. -fu,1/4-€s, c Office Phone: f 76. -w/6 Fax
Co. Address: 3a t .9.3.-.44-3 I( rz/S47 3 City: THx State:i 9 Zip: 3�.-)46
License Holder: 3'e,,0.. Z-1-/ // S Certification/Registration# Li- 3.)78/
Notarized Signature of License Holder < ��
wacknowledged before me this ,� of in t e State of The foregoi�strument as _I ay � � Florida,
County of ,L )LjV G \ C_---'Signature of Notary Public
r
' s.•t�s.�' . TONI GINDLESPERGER
A :_�. "''F�:. [ ] Personally Known OR [ ] Produced Identification
-„r ,,_ MY COMMISSION#GG 353178
EXPIRES:October 6,2023 Type of Identification: l .I.
''d f,*s' Bonded Thru Notary Public Underwriters
•, Updated 10/9/18