307 4th St ACRS21-0022OWNER:ADDRESS:CITY:STATE:ZIP:
FLETCHER WILLIAM DAVID 101 BENT PINE CT PONTE VEDRA
BEACH FL 32082
COMPANY:ADDRESS:CITY:STATE:ZIP:
Taylor Refrigeration
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
169829 0000 ATLANTIC BEACH
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
307 4TH ST MECHANICAL RESIDENTIAL
HVAC 2 AC Units 5 Ton, 2 Ton $19800.00
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
AC AND REFRIGERATION 455-0000-322-1000 7 $56.00
AIR DUCT SYSTEM 455-0000-322-1000 2729 $28.00
FURNACES AND HEATING 455-0000-322-1000 84000 $28.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.51
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: 2/2/2021
PERMIT NUMBER
ACRS21-0022
ISSUED: 2/2/2021
EXPIRES: 8/1/2021
MECHANICAL RESIDENTIAL HVAC
PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $171.51
2 of 2Issued Date: 2/2/2021
PERMIT NUMBER
ACRS21-0022
ISSUED: 2/2/2021
EXPIRES: 8/1/2021
MECHANICAL RESIDENTIAL HVAC
PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $171.51
ACRS21-0022 Address: 307 4TH ST APN: 169829 0000 $171.51
MECHANICAL $167.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
AC AND REFRIGERATION 455-0000-322-1000 7 $56.00
FURNACES AND HEATING 455-0000-322-1000 84000 $28.00
AIR DUCT SYSTEM 455-0000-322-1000 2729 $28.00
STATE SURCHARGES $4.51
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.51
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL FEES PAID BY RECEIPT: R14775 $171.51
Printed: Tuesday, February 2, 2021 1:19 PM
Date Paid: Tuesday, February 02, 2021
Paid By: Taylor Refrigeration
Pay Method: CREDIT CARD 419484443
1 of 1
Cashier: CG
Cash Register Receipt
City of Atlantic Beach
Receipt Number
R14775
Mechanical Permit Application
ALL INFORMATION
j
z^
j1'%,
Application HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 IOU 2 ) -00 2.Z
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: RES Z O " OO lF
JOB ADDRESS: 301 .1-th S•h'L C+ Atlantic, B ch,FL3Z233 PROJECT VALUE $ I CI r OO D 0
NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI#(RE IRED)
2° 5Sf3ti149/
c2S?I?
Air Handling Equipment Only 0 Condenser Only Air Handling Unit& Condenser
Air Conditioning: Unit Quantity Tons per Unit 5544.2-)c:,,
Heat: Unit Quantity BTUs per Unit c,p,00o Seer Rating (REQUIRED) It
Duct Systems:Total CFM I cicp-t a`1,o0a
135
DREPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI#(REQUIRED)
Air Handling Equipment Only 0 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)
FIRE PLACES EI 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 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: I'V 11 I I a m Divi c4 F I c-t&h tr Phone Number:
Mechanical Company: 7-61,110r- Q f.-a--1 yc raft on-i- A IC Office Phone:clO4g 2933 Fax
Co. Address: Po box i21- 0
J
City:St•i\--" t S h n c State:FL_ Zi p:3 20&S
License Holder: 1N O Cit. 14 -j I t C 1 State Certification/Registration# CA C.O S 7 g• 90
Notarized Signature of License Holder I
The foregoing.instrument was acknowledged before me thisgaI day on LUQ , 20 al, in the State of Florida,
County of . ,s6r 15C61`a- 1
Signature of Notary Public
f
Notary Public State of Florida
Chelsea Lewis personally Known OR [ ] Produced Identification
My Commission GG 951290
a Expires 02102/2024 Type of Identification: ID
Updated 10/9/18