1768 BEACH AVE ACRS21-0013 ,,,, #;..„ , .„.
r- Mechanical Permit Application **ALL INFORMATION
HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
ACRS Z( -0DI
800 Seminole Rd, Atlantic Beach, FL 32233 3
-Y,.,,, ,,, Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: PfR r i2 v 67' (
JOB ADDRESS: 176 e Q>?q c \ Iv 0 r' . PROJECT VALUES l )G 6 be 6°
11-NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI#(REQUIRED) 2.0 X13 73 5 51
0 Air Handling Equipment Only 1- ik 0 Condenser Only [i'Air Handling Unit& Condenser
Air Conditioning: Unit Quantity 2 1,33 Tons per Unit 2-1-S I-z.O
Heat: Unit Quantity BTUs per Unit27 / Z,�o64 Seer Rating (REQUIRED) �
, � ,)C
Duct Systems: Total CFM Z 6�('
(REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI#(REQUIRED)
0 Air Handling Equipment Only 0 Condenser Only 0 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)
FIRE PLACES fl 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
It Water Heaters Solar Collection Systems
Tanks (gallons)
Wells
OTHER:
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: O L-e e i (Z2 5;a-,,ce, Phone Number: 901--
Mechanical Company: A C o r- rate T a b1 f tJ ii;(a,..)AA-e,.: , Office Phone: 90`/-ziJ-53 5 i, Fax
Co. Address: 2,07/ F N,-Cf t xr-' 3t,. #3 City: 5 cc K 5;,,VY/l e State: le( Zip: 3L Z07
License Holder: 5MI-+1/ SflNgfl^,N Rle ntic)Er State Certification/Registration# 4-AGlII J77/
Notarized Signature of License Holder 9,--,,,,,T4,?,—_ )4,,,:_�
The foregoin: instrument was acknowledged before me this \E'day o(_.- ti..),, 20 c�\, in the State of Florida,
Count • __-_- 1
,�,;�• REBECCA ANN I'. Signature of Notary •ubli Milo_ 1 ' e..W • L..
14''..,�, MY COMMISSION$GG 078215
' c ` EXPIRES:March B,2021i •ersonally Known O' [ 1 Produced Identification
J'•° °!` Boded llu Notary ndegviters , T.• O •entl kation:
Updated 10/9/18