118 4th St ERES22-0190 COAB Permit Form with ConditionsOWNER:ADDRESS:CITY:STATE:ZIP:
BERG H BRADFORD ET AL 4606 YACHT CLUB RD JACKSONVILLE FL 32210-8156
COMPANY:ADDRESS:CITY:STATE:ZIP:
A.G.E. ELECTRICAL
CONTRACTORS 6936 HANSON DR S JACKSONVILLE FL 32205
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
170184 0000 ATLANTIC BEACH
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
118 4TH ST ELECTRICAL RESIDENTIAL 150A/240V/1st phase -
replace burnt meter can $500.00
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
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 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $94.00
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: 8/26/2022
PERMIT NUMBER
ERES22-0190
ISSUED: 8/26/2022
EXPIRES: 2/22/2023
ELECTRICAL RESIDENTIAL PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
Electrical 'Permit Application
City of Atlantic Beach Building Department
800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: ButldinH-Deptra)coab.us PERMIT#:
JOB ADDRESS: 116 4th street PROJECT VALUE SS 500.00
**ALL INFORMATION
HIGHLr&HTED IN
GRAY IS REQUIRED.
JEA INFORMATION REQUIRED ON ALL PERMITS: / 5/^ AMPS 240 VOLTS 1 PHASE
n NEW SERVICE: • Overhead DUnderground UUnderground up Pole
•Residential (Main) Service:
OO-lOOamps C3101-150amps ni51-200amps 0 amps
OCommercial (Main) Service:
•O-lOOamps ni01-150amps Dl51-200amps • amps
Conductor Type ^_ Size
U of Meters
nCT Service amps
•Muiti-FamilY (Main) Service:
MOO amps •l01-150amps ni51-200amps _amps # of Unit Meters
TEMPORARY POLE: _amps
• SERVICE UPGRADE: • amps •CT Service amps
NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.):
•100 amps GlSOamps n200amps • amps E3CT Service amps
_! ADDITIONS, REMODELS, REPAIRS, BUILD-OUTS, ACCESSORY STRUCTURES, ETC:
Outlets/Switches: 0-30amp5 31-lOOamps 101-200amps
AppiiancGS: 0-30amps 31-lOOamps 101-200amps
A/C Circuits: 0-60amps 61-lOOamps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS:
nSwimmIng Pool DSign DSmoke Detectors (Qty) QTransformers KVA • Motors HP
FIRE ALARM SYSTEM (Requires 3 sets of plans):
Qty vo Its/amps
[•J REPAIRS/MISCELLANEOUS:
•Replace Burnt/Damaged|Meter Can DSafety Inspection DPanel Change DOH to UG
•Dther: 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. 1 hereby certify that \e
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: Brad Berg Phone Number: (904) 704-8448
Electrical Company: A-Q.E. ElecU-ical Contractors Inc
Co. Address: '1;014 Fountain-Road'• --
Office Phone: <W)r«M37o Fax:
City: Jacksonville State; Ft zip: 32205
License Holder: Rofaert Bradlev Smith State Certification/Registration #: EC13001132
Notarized Signature of License Holder
ThefjjrgggyTg^ij||ti^^ijg3j^ before me this_^3_day of /) U^M5?^,,20 ZZ, in the State of Florida, County of OtiuAL
Notiry *ut\K • Statf of Flwidi
'^S^' My Comm. Expires Jul 1.1036
BondKi throtj(h Hjtional Noiiry Aisr.
Signature of Notary Public,
^Personally Known OR [
Type of Identification:
Produced Identification
ERES22-0190