1820 Ocean Grove Dr GSRS2109983 5 Gas Outlets js-51-t.Irp, MECHANICAL RESIDENTIAL GAS PERMIT NUMBER
�. ' SP GSRS21-0083
rwr,,, PERMIT
ISSUED: 8/20/2021
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_j,„ CITY OF ATLANTIC BEACH EXPIRES: 2/16/2022
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: j PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
5 Gas Outlets: NEW
1820 OCEAN GROVE DR MECHANICAL RESIDENTIAL GAS SFH,PRIVATE PROVIDER for $1500.00
INSPECTIONS ONLY
TYPE OF REAL ESTATE ,k BUILDING USE
CONSTRUCTION: NUMBER: ZONING: GROUP: SUBDIVISION:
169622 0000 OCEAN GROVE UNIT 02
COMPANY: ADDRESS: CITY: STATE: ZIP:
TUBE WORKS 9652 CHUTNEY CT JACKSONVILLE FL 32205
OWNER: , ADDRESS: CITY: STATE: s ZIP:
SEAN KILEY 2120 NW 100TH STREET GAINESVILLE Ft 37606
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT It
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.
I.
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
GAS PIPING OUTLETS 455-0000-322-1000 5 $12.00
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
TOTAL:$71.00
Issued Date:8/20/2021 1 of 2
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Mechanical Permit Application **ALL INFORMATION
v ` "\ HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 _
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT# (( 527 ()
JOB ADDRESS: /e-A9 C9 n(7,,,,f) Gne2&' 6iZ, PROJECT VALUE$ / (t C CZ
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 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)
L!A FIRE PLACES 1 I MISCELLANEOUS:
Prefabricated Fireplace (Qty) Automobile Lifts
Gas Piping Outlets f/ Boilers BTUs
Elevators/Escalators
KI,ALL OTHER GAS PIPINGHeat Exchanger
Quantity of Outlets 7 Pumps
#Vented Wall Furnaces Refrigerator Condenser BTUs
#Water Heaters Solar Collection Systems
// Tanks (gallons)(g
[ [OTHER: /c -( �cIs
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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 p�,orma c of construction.
/
Owner Name: (�VeaC°A i.c e- Phone Number:
Mechanical Company: 7/2e L}c c1(1..5` Office PhoneVUr Y .StF- 32) Fax 7F/-5VfY
Co. Address: /90 o ' 2 7/7c2 City: 01 State:q Zip:so JJ'
License Holder: <7417e_. /4- z /c7 State Certification/Registration# 05 :;:l y
Notarized Signature of License Holder < A K j/
The foregoing instrument was acknowledged before me this 20 day of AV &U),202 I, in the/State
{of�Florida,
County of Cil
`
Signature of Notary Public
vp'ra CHRISTIAN GILES
: �.,, •:*, MYCOMMISSION#HH117153 [ ] Personally Known OR [14/Produced Identification
; P,� EXPIRS.Ap113,2025;°,foPType of Identification: P.(, 0 L
•„driM1„
Bated Thu Notary Public Unde4writers
Updated 10/9/18