1355 OCEAN BLVD ERES21-0228 (----
114cr�� . ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER ERES21-0228
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ISSUED: 9/22/2021
�u:avr ATLANTIC BEACH. FL 32233 EXPIRES: 3/21/2022
MUST CALL INSPECTION PHONE LINENEXT
(904) 247-5814 BY 4 PM FOR 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:
1355 OCEAN BLVD ELECTRICAL RESIDENTIAL ELECTRICAL- ONE OUTLET $13660.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
171841 0020 MAN DALAY
COMPANY: I ADDRESS: CITY: STATE: ZIP:
DANCIN ENTERPRISES INC. 3540 BETZ LANDING DR JACKSONVILLE FL 32226
(ELEC)
, OWNER: ADDRESS: CITY: STATE: I ZIP:
JOSH NUSSBAUM 1355 OCEAN BLVD ATLANTIC BEACH FL 32233
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 q'
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
ELEC LIGHTING OUTLETS,INCLUDING FIXTURES 455-0000-322-1000 1 $0.60
ELECTRICAL 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:$59.60
Issued Date:9/22/2021 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 r cc
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: E.RCJ .(-UZZE
JOB ADDRESS: 1355 Ocean Blvd. PROJECT VALUE $$ 13,660.00
JEA INFORMATION REQUIRED ON ALL PERMITS: AMPS VOLTS PHASE
ri NEW SERVICE: ❑Overhead ❑Underground ❑Underground up Pole
Dtesidential (Main) Service:
00-100 amps 0101-150amps 0151-200amps ❑ amps #of Meters
❑Commercial (Main) Service:
00-100 amps 0101-150amps E1151-200amps 0 amps OCT Service amps
Conductor Type Size
❑Multi-Family(Main)Service:
❑0-100 amps 0101-150amps 0151-200amps 0 amps #of Unit Meters
ri TEMPORARY POLE: amps
SERVICE UPGRADE: ❑ amps OCT Service amps
n NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.):
0100 amps 0150amps 0200amps 0 amps OCT Service amps
❑✓ ADDITIONS, REMODELS, REPAIRS, BUILD-OUTS,ACCESSORY STRUCTURES, ETC:
Outlets/Switches: 100:Ne 0-30amps 31-100amps 101-200amps
Appliances: 0-30amps 31-100amps 101-200amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: It circuits @ kw
Number of Lighting Outlets, Including Fixtures:
III 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
❑ REPAIRS/MISCELLANEOUS:
❑Replace Burnt/Damaged Meter Can ❑Safety Inspection DPanel Change DOH to UG
[Other: Updated 10/17/18
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: Josh Nussbaum Phone Number: (917)428-2842
Electrical Company: DanCin Enterprises Office Phone: (904)696-6711 Fax:
Co.Address: 3540 Betz landing Dr City: Jacksonville State: FL Zip: 32226
License Holder: Daniel R Baker State Certification/Registration#: EC0001710
Notarized Signature of License Holder _�!l-afp�—___--_
The foregoing instrument was acknowledged before me this i<C day of r14'c,20 21 in�thheyState of Florida,County of 1)0141--
:�;" PATRICIA D.HURD & /`�'u'� /
Commission#HH 115411 Signatur of Notary Public 1J l�
Jnr Expires August 8,2025 [ ersonally Known OR[ ] Produced Identificat,ion / f� 'pn / ,,
of 0" ° iBidgN"0�Santos Type of Identification: /�l/(,� .i C-A , J ea-L 1LG�-Q�
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