1962 Colina Ct GSRS21-0078 Gas Piping to GeneratorOWNER:ADDRESS:CITY:STATE:ZIP:
JASON AND LESLIE KELSO 1962 COLINA CT ATLANTIC BEACH FL 32233-4530
COMPANY:ADDRESS:CITY:STATE:ZIP:
AA SERVICE AND REPAIR PO BOX 57896 JACKSONVILLE FL 32241
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
169506 1058 SELVA NORTE UNIT 01
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
1962 COLINA CT MECHANICAL RESIDENTIAL GAS
GAS PIPING - OUTLET TO
GENERATOR AND 2-240 LP
TANKS
$2000.00
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
GAS PIPING OUTLETS 455-0000-322-1000 1 $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 2 $20.00
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: 8/11/2021
PERMIT NUMBER
GSRS21-0078
ISSUED: 8/11/2021
EXPIRES: 2/7/2022
MECHANICAL RESIDENTIAL GAS
PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
TOTAL: $89.00
2 of 2Issued Date: 8/11/2021
PERMIT NUMBER
GSRS21-0078
ISSUED: 8/11/2021
EXPIRES: 2/7/2022
MECHANICAL RESIDENTIAL GAS
PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
Updated 10/9/18
Mechanical Permit Application **ALL INFORMATION
HIGHLIGHTED IN
GRAY IS REQUIRED.City of Atlantic Beach Building Department
800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT #: _____________________
JOB ADDRESS: ______________________________________________ PROJECT VALUE $_____________________
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 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 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: ____________________ _______ Phone Number: Mechanical Company: Office Phone: _________________ Fax Co. Address: City: State: Zip: License Holder: _______ ___ State Certification/Registration # Notarized Signature of License Holder The foregoing instrument was acknowledged before me this _____day of ___________, 20___, in the State of Florida, County of _________________ Signature of Notary Public __________________________________________________
[ ] Personally Known OR [ ] Produced Identification
Type of Identification: _____________________________________________________
_______State Certification/Registration #
Notarized Signature of License Holder
The foregoing instrument was acknowledged before me this _____day of ___________, 20___, in the State of Florida,
GSRS21-0078