2139 SEMINOLE RD ACRS21-0139 r '' MECHANICAL RESIDENTIAL HVAC PERMIT NUMBER
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PERMIT ACRS21-0139
�V ISSUED: 4/30/2021
,l;,, CITY OF ATLANTIC BEACH EXPIRES: 10/27/2021
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: I DESCRIPTION: VALUE OF WORK:
2139 SEMINOLE RD MECHANICAL RESIDENTIAL private provider-1 A/C, 1 $5500.00
HVAC AHU, 3 TON
TYPE OF ' REAL ESTATE j BUILDING USE
ZONING: SUBDIVISION:
CONSTRUCTION: NUMBER: ; GROUP:
169515 0500 SECTION LAND
COMPANY: ; ADDRESS: CITY: STATE: ZIP:
ANGLER HEATING &AIR 4533 SUNBEAM RD SUITE 403 JACKSONVILLE FL 32257
INC.
OWNER: ADDRESS: I CITY: STATE: ZIP:
Camille Adams 2139 SEMINOLE RD ATLANTIC BEACH FL 32233-5921
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT If\
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.
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
AC AND REFRIGERATION 455-0000-322-1000 3 $24.00
AIR DUCT SYSTEM 455-0000-322-1000 1200 $20.00
FURNACES AND HEATING 455-0000-322-1000 3600 $24.00
MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
Issued Date:4/30/2021 1 of 2
INFORMATION
NFORMATION
Mechanical Permit Application ALLHIGHLIGHTEDIN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
' 800 Seminole Rd, Atlantic Beach, FL 32233 Pk CI S Z- ( - .3( 39'
' Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: e 0`0
JOB ADDRESS: c,C , ,:31 JCM i/l& e, PROJECT VALUE $ 3'-29 69
I I NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI#(REQUIRED)
u 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) /c Y 73
❑ Air Handling Equipment Only ❑ Condenser Onl it Handling Unit& Condenser
Air Conditioning: Unit Quantity ,7 Tons per Unit
Heat: Unit Quantity BTU's Per Unit ' Seer Rating (REQUIRED) /Li
Duct Systems: Total CFM 13t E'
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 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
n 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 constructionthe performance of construction.
Owner Name: 36-V2/10 [ Id c� Phone Number: Te) , ( t.� p>
Mechanical Company: Office Phone: '('"% �)Y'13 Fax
Co.Address: 9E 11 rmce jor\ S1 � City: Si& State: 3:: _:,--,-(
Zip: /-
License Holder: /32AA' U 6}-L1C _ State Certification/Registration#(40 37b&Y
Notarized Signature of License Holder I'L'
The foregogrn �i s�rument s acknowledged before met 'sF Jay of P\A , 2 , in the State of Florida,
County ofd )0�
Signature of Notary Public ` -
`Z Y�V'•'• TONI GINDLESPERGER
.t•' '; [ J .PEfonally Known OR [ ] Produced Identification
1. • = MY COMMISSION#GG 353178
'Al�' '" �' T e of Identification:
-�;�: EXPIRES:October 6,2023
-"''QO•`rt' Bonded Thru Notary Public Underwriters Updated 10/9/18