61 ARDELLA RD ERES23-0192 C1.J-
,
V"` ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
s
si CITY OF ATLANTIC BEACH ERES23-0192
ISSUED: 8/21/2023
800 SEMINOLE ROAD
�';'9` ATLANTIC BEACH, FL 32233 EXPIRES: 2/17/2024
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:
61 ARDELLA RD ELECTRICAL RESIDENTIAL SAFETY INSPECTION $250.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
172032 0000 SECTION LAND
COMPANY: ADDRESS: CITY: STATE: ZIP:
Service of Knights LLC 415 N 4th Avenue Jacksonville Beach FL 32250
OWNER: ADDRESS: CITY: STATE: ZIP:
BOEREM DAVID L 61 ARDELLA RD ATLANTIC BEACH FL 32233-4305
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.
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
ELECTRICAL BASE FEE 455-0000-322-1000 0 $55.00
SAFETY INSPECTION 455-0000-322-1000 0 $50.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$109.00
Issued Date:8/21/2023 1 of 2
Electrical Permit Application **ALL INFORMATION
HIGHLIGHTED IN
�/ City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233
( ) C-RS?3 `0192
Phone: 904 247-5826 Email: Building-Dept@coab.us PERMIT
JOB ADDRESS: p / i, 'Wel'
PROJECT VALUE $ --5.C%
JEA INFORMATION REQUIRED ON ALL PERMITS: 2' ' AMPS z--4ta VOLTS 1- PHASE
NEW SERVICE: ❑ Overhead ❑Underground ❑Underground up Pole
❑Residential (Main) Service:
❑0-100 amps o101-150amps o151-200amps ❑ amps #of Meters
❑Commercial (Main) Service:
❑0-100 amps E101-150amps o151-200amps ❑ amps ❑CT Service amps
Conductor Type Size
❑Multi-Family(Main)Service:
❑0-100 amps o101-150amps o151-200amps ❑ amps #of Unit Meters
n TEMPORARY POLE: amps
D SERVICE UPGRADE: ❑ amps ECT Service amps
NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.):
❑100 amps ❑150amps ❑200amps ❑ amps ❑CT Service amps
ADDITIONS, REMODELS, REPAIRS, BUILD-OUTS,ACCESSORY STRUCTURES, ETC:
Outlets/Switches: 0-30a m ps 31-100amps 101-200a m ps
Appliances: 0-30a nips 31-100amps 101-200amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS:
❑Swimming Pool ❑Sign ❑Smoke Detectors (Qty) ❑Transformers KVA ❑Motors HP
n FIRE ALARM SYSTEM (Requires 3 sets of plans):
Qty volts/amps
I REPAIRS/MISCELLANEOUS:
❑Replace Burnt/Damaged Meter/Can ❑Safety Inspection ❑Panel Change ❑OH to UG
❑Other: S a+6-1-y i`4 Sl1 ie✓I Updated l0/17/18
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: ✓`3 t- 6 c e re../41W-----'N,NPhone Number: 2 3 7-6 ' 7.
Electrical Company:p y: z7er0,��- ��•� S G Office Phone: Fax:
t / '
Co.Address: 1 i s /)� City: �;,v _ jt:c,4 State: r( Zip: ;Z 2 a
License Holder: LU _ ate Certification/Registration#: 6Zj2 /3 a I- 5 3?- c/
Notarized Signature of License Holder or , / ,
,`%', 4.�� bi)1/4..-1
The foregoing instrument was acknowledged before me this Z day of IL�� 2' 411_ the State of Florida,County of
. .. . y,:,nature of Notary Public - -- i
`� .4(1'4',.;,„
YueTONI GINDLESPERGER
'r�.'.. ._<'i' MYCOMMISSION#GG353176 (.. 'ersonally Known OR i ] Produced Identification
l ', "r • . A e of Identification:
; 'z,.o; EXPIRES:October 6,2023 p
of e�°�:' Bonded Thru Notary Public Underwriters