871 Ocean Blvd ACRS21-0252 App ‘„0->,v„, Mechanical Permit Application **ALL INFORMATION
HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
.) is. )) 800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:
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JOB ADDRESS: ilk OCcar N . �A PROJECT VALUE $ I(4 4.11 .
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
1.014 g 3 3
REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION ARI#(REQUIRED) 1,511..4 I, 1%S
❑ Air Handling Equipment Only ❑ Condenser Onl L'Air Handling Unit& Condenser
Air Conditioning: Unit Quantity Z Tons per Unit ''>,
Heat: Unit Quantity BTU's Per Unit L a Seer Rating (REQUIRED) lc-
Duct
-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 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
fl 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.
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Owner Name: Y,o1oerk A.5 `` J Q .\' r Phone Number: tit - )Z4 -Olt.
Mechanical Company: ��C 1,SO.4jtS ea't'.tw) G Office Phone: t{eti'toc11-x')1'3 Fax
Co. Address: �1 k pup() f`U b City:j ac k5,on,itc, State: Ft Zip: 222,5.
License Holder: RZ LL 4R./..SWN State Certification/Registration# IL C- <%k 4 A.0'
Notarized Signature of License Holder ‘-,
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The fore o n acknowledged before me this da of , 20 , in th- . . - of Florida,
Count of g
County Signature of Notary Publ . A� ` _ •ia� I, ja110.4.0 A,'_ 1
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NotaryPublicStene ofFlorWeTara i. a t1eR Bel"F Personally Known OR [ ] Produced Identification
j My Cortxrwaaon HH 118866 Ty e of Identification:
%co Exares 06/06/225
Updated 10/9/18
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