175 15th Street ERES22-0087 Electircal Permit ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH ERE522-0087
800 SEMINOLE ROAD ISSUED:4/14/2022
ATLANTIC BEACH. FL 32233 EXPIRES: 10/11/2022
INSPECTIONMUST CALL • • I • FOR NEXT DAY INSPECTION.
ALL IMTRY,
CODE, NEC, IPIMC, 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.
• • • r . • . • OF WORK:
175 15TH ST ELECTRICAL RESIDENTIAL ELECTRIC FOR REMODEL $750.00
SUBDIVISION:TYPE OF REALESTATE ZONING: BUILDING USE
CONSTRUCTION: NUMBER: GROUP:
171869 0000 MANDALAY
COMPANY: rr •
RIVER CITY ELEC 12496 NE GATELY OAKS L JACKSONVILLE FL 32225
CONTRACTORS
ADDRESS: CITY: STATE: ZIP:
JOHNSON R MARK 175 15TH ST ATLANTIC BEACH FL 32233-5723
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.
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
ELEC LIGHTING OUTLETS,INCLUDING FIXTURES 455.0000-3221000 7 $4.20
ELECTRICAL BASE FEE 4550000-322-1000 0 $5500
STATE DBPR SURCHARGE 4550000-20807M 0 $200
STATE DCA SURCHARGE 455-CO 208-0600 0 $2.00
TOTAL:$63.20
Issued Date:4/14/2022 1 of 2
Electrical Permit Application "ALL INFORMATION
HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY 15 REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 �-7�Sz Z- 0087
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:
JOB ADDRESS: 2 5— 15fih PROJECT VALUE
JEA INFORMATION REQUIRED ON ALL PERMITS:CAMPS / O VOLTS L PHASE
❑ NEW SERVICE: Overhead oUnderground ❑Underground up Pole
❑Residential(Main)Service:
❑0-100amps n101-150amps u151-200amps ❑_amps If of Meters_
❑Commercial(Main)Service:
❑0-100amps n101-150amps u151-200amps ❑_amps ❑CT Service_amps
Conductor Type Size
❑Multi-Family(Main)Service:
00-100amps o101-150amps o151-200amps ❑_amps #of Unit Meters_
❑ TEMPORARY POLE: amps
❑ SERVICE UPGRADE: ❑ amps ❑CT Service amps
❑ NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES, ETC.):
❑100amps ❑15Oamps ❑200amps ❑ amps ❑CTService_amps
ADDITIONS, REMODEP, REPAIRS, BUILD-OUTS,ACCESSORY STRUCTURES,ETC:
Outlets/Switches: 0-30amps 31-100amps 101-200amps
Appliances: 0-30amps 31-100amps 101-200amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: #circuits @ kw Z—
Number of Lighting Outlets, Including Fixtures:
❑OTHER ELECTRICAL PROJECTS:
o5wimming Pool ❑Sign oSmoke Detectors (Qty) oTransformers 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 ❑OH to UG
❑Other: updo ed io/1718
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. /r O� l�UG ,rem
Owner Name: �a ri 7�' fi Phone Num6ec
Electrical Company:2,'uLFleACr1^ / Office Phone: QOy^ 13 YS-32o2- Fax:61 �-
Co.Address: /PW96 �(.ifX- /)i' ,✓1 !_/! r r City:;)�4& State: Zip: 3z'LZS
License Holder. 0% state Certification/Registration 6'0 3f
Notarized Signature of License Holder
The foregoing instrument was acmowl efor ethicL of ZA 20�a� a State of Florida,County of �UV,
Signature of Notary Public
�^'.°.'`._ TONT GINDLESPERGER Perwnally Known OR[ I Produced Identification
MYCOMMISSION FG033377g Type of Identification:
':y' $+ EXPIRES:Wooer 1,2023
•�IP.�..',\"�' BOMed ihmfloury Public UiWrmNn