1707 Beach Ave GSRS21-0074 Gas for Kitchen, bath remodel t Lys
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MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
�. � GSRS21-0074
;y'� PERMIT
ISSUED: 7/14/2021
\�,3 ,`r CITY OF ATLANTIC BEACH EXPIRES: 1/10/2022
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:
Gas for: KITCHEN & BATH
1707 BEACH AVE MECHANICAL RESIDENTIAL GAS REMODEL, DECK, SIDING & $1500.00
WINDOWS
TYPE OF : REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: _ NUMBER: GROUP:
169660 0000 NORTH ATLANTIC BCH
UNIT 1
COMPANY: ADDRESS: CITY: STATE: ZIP:
TUBE WORKS 9652 CHUTNEY CT JACKSONVILLE FL 32205
OWNER: ADDRESS: CITY: STATE: ZIP:
MALLOY JENNIE S 1707 BEACH AVE ATLANTIC BEACH FL 32233-5838
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.
I
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 4 $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
Issued Date:7/14/2021 1 of 2
MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
PERMIT GSRS21-0074
ISSUED: 7/14/2021
CITY OF ATLANTIC BEACH EXPIRES: 1/10/2022
TOTAL:$69.00
Issued Date:7/14/2021 2 of 2
Mechanical Permit Application **ALL INFORMATION
HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:&SRS ZI _ X74
JOB ADDRESS: C 70? Cl'-2c.,1/4_0// A U P PROJECT VALUE I'�GC- c
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1 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 Ii 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)
F (FIRE PLACES I MISCELLANEOUS:
Prefabricated Fireplace (Qty) Automobile Lifts
Gas Piping Outlets / Boilers BTUs
Elevators/Escalators
ALL OTHER GAS PIPING _____? Heat Exchanger
Quantity of OutletsPumps
#Vented Wall Furnaces Refrigerator Condenser BTUs
# Water Heaters Solar Collection Systems
Tanks (gallons)
/� /(/ Wells
rlOTHER: ( rt €
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: Phone Number:
,. / T / lar(-syr
Mechanical Company: �� �� �C/B� �S' `- L° Office Phone:�� � V�J..�a?7 Fax
Co. Address: e6sx lk 7/( a City: J7StateZip:.?Q)o.&G
License Holder: Zile- ' r ( 0 ,/ — State C-rt. , /Registration# 0-47 I
Notarized Signature of License Holder - A ,• -
10
40
The foregoing instrument was acknowledged before me this )/ day of U I,y , 20 2(, in the State of Florida,
County of 1)0 V Pt iv
Signature of Notary Public (/�'�4. • ..._ vC/�
" CHRISTIAN GILES
=_ MY COMMISSION#HH 117153 [ ] Personally Known OR [-roduced Identification
.�• '• 'r"• 41. '* EXPIRfiS:Aprr113,2025 T e of Identification: L 10
.:ori,:a'' Banded Ttvu Notary Pubic Underwriters
Updated 10/9/18