2375 SEMINOLE RD ERES22-0038 ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
A „ CITY OF ATLANTIC BEACH ERES22-0038
800 SEMINOLE ROAD ISSUED: 2/28/2022
ATLANTIC BEACH. FL 32233 EXPIRES: 8/27/2022
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:
2375 SEMINOLE RD ELECTRICAL RESIDENTIAL ELECTRICAL FOR INTERIOR
REMODEL $6000.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
168908 8510 SAND DOLLARS
COMPANY: ADDRESS: CITY: ! STATE: ZIP:
SOUTHEAST ELECTRICAL
OWNER: ADDRESS: CITY: STATE: ZIP:
PORGES SETH COLIN 2375 SEMINOLE RD 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
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
ELEC LIGHTING OUTLETS,INCLUDING FIXTURES 455-0000-322-1000 50 $30.00
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:$89.00
Issued Date:2/28/2022 1 of 2
Electrical Permit Application **ALL INFORMATION
�����''� �� HIGHLIGHTED IN
(,. City of Atlantic Beach Building Department GRAY IS REQUIRED.
' %�;' 800 Seminole Rd, Atlantic Beach, FL 32233 E RESZ Z — 0037
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: QESZZ–QNQ
JOB ADDRESS: Z7:77 3eP1r t e ) Ffri fri PROJECT VALUE$ 57_1°o
i 7%
JEA INFORMATION REQUIRED ON ALL PERMITS: a°c7 AMPS '2YDVOLTS L PHASE
NEW SERVICE: ❑ Overhead ❑Underground ❑Underground up Pole
❑Residential (Main)Service:
r 0-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Meters
-Commercial (Main) Service:
0-100 amps ❑101-150amps ❑151-200amps ❑ amps ❑CT Service amps
Conductor Type Size
❑Multi-Family(Main) Service:
0-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Unit Meters
TEMPORARY POLE: amps
SERVICE UPGRADE: ❑ amps ❑CT Service amps
NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.):
100 amps __150amps 200amps _ amps DCT Service amps
ADDITIONS, REMODELS, REPAIRS, BUILD-OUTS, ACCESSORY STRUCTURES, ETC:
Outlets/Switches: / 0-30amps 31-100amps 101-200amps
Appliances: a. 0-30amps 31-100amps 101-200amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures: /t
OTHER ELECTRICAL PROJECTS:
❑Swimming Pool Sign ❑Smoke Detectors (Qty) ❑Transformers KVA ❑Motors HP
FIRE ALARM SYSTEM (Requires 3 sets of plans):
Qty volts/amps
REPAIRS/MISCELLANEOUS:
❑Replace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel 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: .SVS"Ct IU V/1`iA.4-?" Phone Number: 1C / 31 u `12. 2-5
Electrical Company: 5oUT1.- Ot51 E ECrtAGt t't— Office Phone: 9.-eq 3i1-1 -477) Fax:
Co.Address: ( 700 13)zo 'F'i2A) FA--i DL*-tetic City: .SICK-` IL.(.L State: .-- Zip: JZZI'6
License Holder:� -;1N Lvkf�1�-r State Certification/Registration#: `LC I J ��U
7
Notarized Signature of License Holder
The foregoing instrument was acknowled ore me this4day of _-1 +1 20- F. he State of Florida,County V2–)0 4r0.,`
Signature of Notary Public — ' i
LYpuk
TONIGNDLESPERGER [ ] Personally Known OR[ ] Produced Identification
MYCOMMISSION#GG 353178 - Type of Identification: D
EXPIRES:October 6,2023
F�O� Bonded Thru Notary Public Utder*,iters
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