APP-M-24-218658CITY OF IIELNIIY BENCH
C/U MODEL NO. & C/B SIZE DRACI4A24AJ1AN 30/30 KW 5 K
RIAL):
H.P. or BTU
E.V.A.P. Model #:
Effic'y Rating:
PROJECT COST (LABOR AND MA
HVAC: **ANYTHING OVER 5 TONS MAY REQUIRE FIRE DEPT. REVIEW/APPROVAL**
A.H.U. MODEL NO. & C/B SIZE DRAH2TA2417AST
BTUH CAPACITY 22800 S.E.E.R RATING 16.00 PACKAGE UNIT:
DUCTWORK: (Y) NO (N)
TOTAL PROJECT COST (LABOR AND MATERIAL): $ $6884.00
C/B SIZE 30/30
Before Rebates
HOODS - EXHAUST- BOOTH - BLOWER (2 SETS OF PLANS REQD)
Booth:
Hoods:
SUPPRESSION
Wet Chem:
EMS (3 SETS OF PLANS REQD)
H2O:
Clean Agent: Dry -
PROJECT COST (LABOR AND MATERIAL):
$
FRIGERATION
E.. .ment Type:
C.U. "-INo.:
$
BLDG PERMIT #:
MECH PERMIT #:
PERMIT FEE:
PLAN CHECK FEE:
MCR#:
APPROVALS:
MECH: DATE:
PLAN: DATE:
FIRE: DATE:
INDICATE IF
SMOKE TEST IS REQUIRED
OR 64974
WORKERS COMP# EXEMPT (FID /FEIN) # SIGNATURE OF QUA FIER
CACO24382
CONTR. REGISTRATION #
STATE OF FLORI A
COUNTY OF PAl BFACH
The foregoing instru ent was acknowledged
this 22nd dy of MAY
Signature of Notary Publ - State of Florida
A5ii-at4a
REV 5/2023
ysical presence or [] online notarization
WALTER WEISS, JR
(Printed Name of Above Signatory)
Personally Known XXX
OR
Produced Identification
Type of Identification Produced
100 NW 151 Avenue Delray Beach FL 33444
(561) 243-7200 Fax: (561) 243-7221
Webs ite: www.delravbeachfLqov
MECHANICAL PERMIT APPLICATION
(HVAC, REFRIGERATION, HOODS, SUPPRESSION)
0
FOR OFFICE USE ONLY:
PROPERTY CONTROL#: 12 ..43 .46 ..20 01 ..018 .0010
PLEASE PRINT: FILL IN COMPLETELY. INDICATE "N/A" WHERE APPLICABLE.
JOBSITE ADDRESS 1500 SW 6TH STREET
PROPERTY OWNER NAME CITY OF DELRAY BEACH
HOME PHONE ( 561 ) 243 - 7339 CELL ( ) CLAYTON
PROPERTY OWNER ADDRESS 100 NW 1ST AVE
MECHANICAL CONT'R (COMPANY) NAME A-EXCELLENT SERVICE, INC
MECHANICAL CONT'R (COMPANY) ADDRESS 9121 N MILITARY TRL, STE 103
CITY PALM BEACH GARDENS ST FL ZIP 33410
BUS. PHONE( 561 ) 383-3855 CELL( )
E-MAIL aexcelIentserv@aol.com FAX(
NOTE: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180-DAYS OR IF ACTIVITY LAPSES FOR 180 DAYS. PLANS
MUST BE ON THE JOB SITE FOR ALL INSPECTIONS. FINAL INSPECTION IS REQUIRED ON ALL PERMITS.
TYPE OF INSTALLATION - CHECK ALL THAT APPLY FOR THIS CONTRACTOR:
DESCRIPTION OF WORK: RESIDENTIAL NEW IS THIS AN EXACT CHANGE-OUT?
xxx COMMERCIAL xxx REPLACEMENT YES NO
ADDI ONAL 1, SCRIPTION 'E FO LIKE C/O OF (1)2-TON SPLIT AC SYSTEM, NO ELECTRIC, NO DUCTING