643 SELVA LAKES CIR ERES22-0125 COAB Permit Form with ConditionsOWNER:ADDRESS:CITY:STATE:ZIP:
FOLAN KATHLEEN M
REVOCABLE LIVING TRUST 643 Selva Lakes Circle Atlantic Beach Fl 32233
COMPANY:ADDRESS:CITY:STATE:ZIP:
D & L QUALITY ELECTRIC
INC 2368 MILLS RD JACKSONVILLE FL 32216
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
172027 5902 SELVA LAKES UNIT 03
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
643 SELVA LAKES CIR ELECTRICAL RESIDENTIAL ELECTRIC FOR SUNROOM $250.00
FEES
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
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: 6/1/2022
PERMIT NUMBER
ERES22-0125
ISSUED: 6/1/2022
EXPIRES: 11/28/2022
ELECTRICAL RESIDENTIAL PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
ERES22-0125
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $59.60
ERES22-0125 Address: 643 SELVA LAKES CIR APN: 172027 5902 $59.60
ELECTRICAL $55.60
ELECTRICAL BASE FEE 455-0000-322-1000 0 $55.00
ELEC LIGHTING OUTLETS, INCLUDING
FIXTURES 455-0000-322-1000 1 $0.60
STATE SURCHARGES $4.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL FEES PAID BY RECEIPT: R19734 $59.60
Printed: Wednesday, June 1, 2022 3:24 PM
Date Paid: Wednesday, June 01, 2022
Paid By: D & L QUALITY ELECTRIC INC
Pay Method: CREDIT CARD 645867821
1 of 1
Cashier: TG
Cash Register Receipt
City of Atlantic Beach
Receipt Number
R19734