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1841 ATLANTIC BEACH DR MCRS25-0012 Permit Form with Conditionsl AN ELECTRICAL PERMIT IS REQUIRED FOR JEA l Use of existing/proposed structure(s): Commercial Residential l If existing structure, is a fire sprinkler system installed?: Yes No l Smoke Detectors or Thermal Detectors SOLAR PANEL SYSTEM PERMIT APPLICATION City of Atlantic Beach Building Division 800 Seminole Road, Atlantic Beach, FL 32233 Phone: (904) 247-5826 Email: Building-Dept@coab.us Job Address Legal Description RE# Valuation of Work (Replacement Cost) Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all the laws regulating construction in this jurisdiction. 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 city/county, and there may be additional permits required from other governmental entities such as water management districts, state agencies, or federal agencies. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. **WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOU PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE SITE OF THE IMPROVEMENT BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. FOR INTERNAL OFFICE USE ONLY PERMIT # ____________________ **ALL information required to process DATEPRINT OR TYPE NAME OF OWNER OR AGENTSIGNATURE OF OWNER OR AGENT "In lieu of signed, sworn and notarized signatures of the property owner, agent and/or contractor, and under penalties of perjury, I declare that I have read and examined the foregoing application and that the facts stated in it are true and correct." Expiration DateOR ExemptWorker's Compensation Insurer Job Site Contact NumberEmail State Certification/Registration#Qualifying Agent ZipStateCityAddress PhoneName of CompanyCONTRACTOR Owner or Agent Email ZipStateCityAddress PhoneNamePROPERTY OWNER Describe in detail the type of work to be performed: SIGNATURE OF CONTRACTOR PRINT OR TYPE NAME OF CONTRACTOR DATE Solar Permit Application 07.03.2025 1841 ATLANTIC BEACH DR ATLANTIC BEACH, FL 32233 67-132 08-2S-29E .152 ATLANTIC BEACH COUNTRY CLUB UNIT 2 LOT 48 169505-1535 $67,127 08-26-2025 GRZEGORZ BRZEZICKI 10/18/2025Bridgefield Employers Insurance Co 904-618-3820permits@a1asolar.com CVC56771JOSEPH PETER WILKING 32226FL Jacksonville 10418 New Berlin Road Unit 223 (904) 468-7861A1A SOLAR CONTRACTING, INC g.brzezicki@yahoo.com 32233FL ATLANTIC BEACH1841 ATLANTIC BEACH DR (216) 258-9341GRZEGORZ BRZEZICKI To install a grid-tied rooftop solar PV system with Sol-Ark 15KW & RENON 16kWh integrated battery system -PV Modules: (43) JA Solar Holding JAM54D41-440/MB -Battery(ies): (2) Renon Power R-XC016161-US (32kWh of Total Storage / 15KW Continuous Power) -Battery-based inverters - grid-tie / off-grid: (1) Sol-Ark 15K [240V] 08-26-2025 J PETER WILKING OWNER:ADDRESS:CITY:STATE:ZIP: BRZEZICKI GRZEGORZ 1841 ATLANTIC BEACH DR ATLANTIC BEACH FL 32233 COMPANY:ADDRESS:CITY:STATE:ZIP: A1A SOLAR CONTRACTING INC 10418 NEW BERLIN 223 JACKSONVILLE FL 32226 TYPE OF CONSTRUCTION: REAL ESTATE NUMBER:ZONING:BUILDING USE GROUP:SUBDIVISION: 169505 1535 ATLANTIC BEACH COUNTRY CLUB UNIT 02 JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK: 1841 ATLANTIC BEACH DR MECHANICAL RESIDENTIAL OTHER SOLAR SYSTEM $67127.00 FEES DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT MECHANICAL BASE FEE 455-0000-322-1000 0 $55.00 SOLAR COLLECTOR SYSTEM 455-0000-322-1000 0 $30.00 STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00 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: 10/16/2025 PERMIT NUMBER MCRS25-0012 ISSUED: 10/16/2025 EXPIRES: 4/14/2026 MECHANICAL RESIDENTIAL OTHER PERMIT CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD TOTAL: $89.00 2 of 2Issued Date: 10/16/2025 PERMIT NUMBER MCRS25-0012 ISSUED: 10/16/2025 EXPIRES: 4/14/2026 MECHANICAL RESIDENTIAL OTHER PERMIT CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD