284 Belvedere St ERES21-0297 Elec for Remodel r�'`vi j' ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
ry 0 CITY OF ATLANTIC BEACH ERES21-0297
'' s 800 SEMINOLE ROAD ISSUED: 12/10/2021
l``'''19',' ATLANTIC BEACH. FL 32233 EXPIRES: 6/8/2022
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: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
284 BELVEDERE ST ELECTRICAL RESIDENTIAL ELECTIC FOR REMODEL $5000.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
170494 0000 SALTAIR SEC 01
COMPANY: ADDRESS: I CITY: STATE: ZIP:
Service of Knights LLC 415 N 4th Avenue Jacksonville Beach FL 32250
OWNER: ADDRESS: CITY: STATE: ZIP:
STOWMARKET HOLDINGS 2002 SAN MARCO BLVD#200 JACKSONVILLE FL 32207
LLC
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.
sa:L" 416, 41111.
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
ELEC LIGHTING OUTLETS,INCLUDING FIXTURES 455-0000-322-1000 0 $0.00
ELEC REPAIRS AND MISC 455-0000-322-1000 0 $35.00
ELECTRICAL BASE FEE 455-0000-322-1000 0 $55.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $3.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
WORK WITHOUT PERMIT 455-0000-322-1000 0 $110.00
Issued Date: 12/10/2021 1 of 2
- �S='""r�� ELECTRICAL RESIDENTIAL PERMIT
f; PERMIT NUMBER
,3
1:1
CITY OF ATLANTIC BEACH ERES21-0297
�~ ISSUED: 12/10/2021
800 SEMINOLE ROAD I
ony* ATLANTIC BEACH. FL 32233 EXPIRES: 6/8/2022
TOTAL:$205.00
Issued Date:12/10/2021 2 of 2
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Electrical Permit Application **ALL INFORMATION
f�\ HIGHLIGHTED IN
�. City of Atlantic Beach Building Department15
GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 C� Lsz I _Oz97
ma'''r Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:
JOB ADDRESS: h`J ei &/l/Qie;e S f. PROJECT VALUE$ 5-5O0
JEA INFORMATION REQUIRED ON ALL PERMITS: 7.-"c-C) AMPS .Z(10 VOLTS Z 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 It of Unit Meters
n TEMPORARY POLE: amps
❑ SERVICE UPGRADE: ❑ amps ECT Service amps
❑ NEW FEEDER (ADDITIONS,ACCESSORY STRUCTURES, ETC.):
❑100 amps ❑150amps ❑200amps ❑ amps (ACT Service amps
fl ADDITIONS, REMODELS, REPAIRS, BUILD-OUTS,ACCESSORY STRUCTURES, ETC:
Outlets/Switches: Z4— 0-30amps 31-100amps 101-200amps
Appliances: 59 0-30amps 31-100amps 101-200amps
A/C Circuits: 2 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
❑ REPAIRS/MISCELLANEOUS:
(=Replace Burnt/Damagedeter Can ❑Safety Inspection r anel ChangeDOH to UG
❑Other: 1 ��� 2 1 / /_ .7 f-Cl„, ( L, /.,,r .-- a ,Pe-•`�,/ c 4/-•jam 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 folate the provisions of ny other state or local law regulation construction or the performance of
construction. (�
Owner Name: - O ,..WYNcU-i-PPhone Number: i y) 7G l-/ ct7
Electrical Company: �rt.r �v„) /,-, Office Phone: 76-, - 6 r y 7 Fax:
Co.Address: y(5^/ / � /.�( E City: /c-,/ «sc / State: Zip: 3 2 ? cLicense Holder:\ /C., /I �, /�a� �� / State Certification/Registration#: iii /-36 i - S-3? i
I C
Notarized Signature of License Holder
The foregoing instrument was ackn edged before me this' n day f (, , 02:1, in the State of Florida,County of
Signature of Notary Public Jd"-----
i
„;,:4,YFy `.. TONI GINDLESPERGER
'•` MYCOfdtdISSIOPJ#GG 353178 l 1 Personally Known OR l I Produce Ten 'fication
7;�? ,,�: EXPIRES:October 6,2023 Type of Identification:
•eO...F`0'' Bonded Thio Notary Public Underwriters