1450 Ocean Blvd GSRS21-0012 Piping —
S�i'..V.rye MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
ilir GSRS21-0012
uv PERMIT ISSUED: 2/1/2021
��;�,; CITY OF ATLANTIC BEACH EXPIRES: 7/31/2021
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.
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:
1450 OCEAN BLVD MECHANICAL RESIDENTIAL GAS Gas Piping 3 Outlets, Water $1400.00
Heater, 250 Gal Tank
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
171853 0000 MANDALAY
COMPANY: ADDRESS: CITY: STATE: ZIP:
FLORIDA PROPANE Griffis 461 TRESCA RD JACKSONVILLE FL 32225
Gas
OWNER: ADDRESS: CITY: STATE: ZIP:
MCEWAN COURTNEY 1450 OCEAN BLVD ATLANTIC BEACH FL 32233
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT II\
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.
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 3 $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
TANKS GAS OR LIQUEFIED PETROLEUM 455-0000-322-1000 250 $20.00
Issued Date:2/1/2021 1 of 2
i'"�''' MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
GSRS21-0012
v`"_ PERMIT ISSUED: 2/1/2021
��3 ,�
JS i CITY OF ATLANTIC BEACH EXPIRES: 7/31/2021
VENTED WALL FURNACE WATER HEATER UNIT l 455-0000-322-1000 1 $5.00
TOTAL:$94.00
Issued Date:2/1/2021 2 of 2
Mechanical Permit Application **ALL INFORMATION
=i-LA.,ren pp HIGHLIGHTED IN
t ik6ki City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233
N,01111.)/
'' Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:
JOB ADDRESS: L\ cu CAC '' � o PROJECT VALUE$ r`koc)
I I 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
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)
n FIRE PLACES n 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 l Solar Collection Systems
Tanks (gallons) 2 c.. Com, .
Wells
I (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: ( cL* cC.w“11 • Phone Number: iz,'t 3l� 2S- `..-
Mechanical Company: - ---( �(�(7...-, c4,!I-A.<<S Office Phone: •,t --oc{ `(3`t FFa 0`{ -?,)-1 V
Co. Address: V.,( 1ft SC,-, el c - City:d--tc Son,.,LtC_ State: `C- Zip: 317222-I--
License
L2ZI--License Holder: ,(.I l `P\ ,�.c C�,J -Z 1)1
egistration# 3(2
Notarized SignatureTTof License Holder l / ( -- Cl
/
The foregointryr ent as acknowledged before me-this l Ce—day —'if�. '0 LL in the State of Florida,
County of k-A/ n�� r
Signature of Notary Public �Q, ` _
-.
,,,s,!‘.:','1,':,, TOi41GINDLESPERGER [ I Personally Known OR [ ] Produced Identification
„. ,•A ...1.:t MY COMMISSION#GG 353178
T. turaType of Identification:
.e..-6, EXPIRES:October 6,2023
" Updated 10/9/18
"*:$', I-:•••• Bondad Thru Notary Public Underwriters P