156 SEMINOLE RD SOLR22-0006 COAB Permit Form with ConditionsOWNER:ADDRESS:CITY:STATE:ZIP:
SIEFKEN DAVID R 156 SEMINOLE RD ATLANTIC BEACH FL 32233-4141
COMPANY:ADDRESS:CITY:STATE:ZIP:
GO SOLAR POWER LLC 933 CLINT MOORE RD BOCA RATON FL 33487
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
170596 0000 SALTAIR SEC 01
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
156 SEMINOLE RD ELECTRICAL SOLAR PANEL ELECTRICAL FOR SOLAR PV
ROOF MOUNTED SYSTEM $500.00
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
ELECTRICAL BASE FEE 455-0000-322-1000 0 $55.00
SOLAR COLLECTOR SYSTEM 455-0000-322-1000 0 $30.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $89.00
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: 9/12/2022
PERMIT NUMBER
SOLR22-0006
ISSUED: 9/12/2022
EXPIRES: 3/11/2023
ELECTRICAL SOLAR PANEL PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
Updated 10/17/18
Electrical Permit Application **ALL INFORMATION
HIGHLIGHTED IN
GRAY IS REQUIRED.City of Atlantic Beach Building Department
800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT #: __________________
JOB ADDRESS: ______________________________________________ PROJECT VALUE $_____________________
JEA INFORMATION REQUIRED ON ALL PERMITS: ______AMPS _____ VOLTS _____ PHASE
NEW SERVICE: □ Overhead □Underground □Underground up Pole
□Residential (Main) Service:
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 □CT Service ______ amps
ADDITIONS, REMODELS, 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
Number of Lighting Outlets, Including Fixtures: _______
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 □OH to UG
□Other:____________________________________________________________________________________________
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: _________ _______ Phone Number:
Electrical Company: Office Phone: ___ Fax:
Co. Address: City: State: Zip:
License Holder: ____________ State Certification/Registration #:
Notarized Signature of License Holder
The foregoing instrument was acknowledged before me this _____day of ___________, 20___, in the State of Florida, County of __________
Signature of Notary Public
[ ] Personally Known OR [ ] Produced Identification
Type of Identification: ______________________________________________________________
156 SEMINOLE RD Atlantic Beach FL 32233 500
4
4
Solar PV Roof-Mounted System And Interconnection
Siefken, David 904-334-7260
Go Solar Power LLC 561-228-4483
933 Clint Moore Rd Boca Raton FL 33487
Dean A Hodge EC13007879
01 July 22
FL D/L
SOLR22-0006
By Mike Jones at 2:32 pm, Aug 02, 2022
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $89.00
SOLR22-0006 Address: 156 SEMINOLE RD APN: 170596 0000 $89.00
ELECTRICAL $55.00
ELECTRICAL BASE FEE 455-0000-322-1000 0 $55.00
MECHANICAL $30.00
SOLAR COLLECTOR SYSTEM 455-0000-322-1000 0 $30.00
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: R20840 $89.00
Printed: Monday, September 12, 2022 8:37 AM
Date Paid: Monday, September 12, 2022
Paid By: GO SOLAR POWER LLC
Pay Method: CREDIT CARD 721710704
1 of 1
Cashier: TG
Cash Register Receipt
City of Atlantic Beach
Receipt Number
R20840