1657 Seminole Rd ERES23-0015 Permit Jsi.-Lvr,,' ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH
ERES23-0015
J V 800 SEMINOLE ROAD ISSUED: 1/31/2023
ATLANTIC BEACH. FL 32233 EXPIRES: 7/30/2023
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORMTO THE CURRENT 6TH EDITION1 OF • '
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF . . 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:
1657 SEMINOLE RD ELECTRICAL RESIDENTIAL ELECTRIC FOR REMODEL $500.00
TYPE OF
ZONING: :D •
• • GROUP:
169564 0030 OCEAN GROVE UNIT 01
COMPANY: ADDRESS:
COOPER ELECTRICAL 89 CODY ST SAINT AUGUSTINE FL 32084
SERVICES LLC
.. • .' ADDRESS:
FIN KLEA ROBBY JAY 1657 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 . •
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 455-0000-322-1000 0 $0.00
ELEC LIGHTING OUTLETS,INCLUDING FIXTURES 455-0000-322-1000 22 $13.20
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: $72.20
Issued Date: 1/31/2023 1 of 2
Electrical Permit Application **ALL INFORMATION
HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
) e�,,�,���r�.♦
800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Em 'I: Building-Dept@coab.us PERMIT#: F 5Z3"�(:
JOB ADDRESS: I� S� S�� .r-�� ��G� PROJECT VALUE $ 5-3,0
1EA INFORMATION REQUIRED ON ALL PERMITS: AMPS VOLTS PHASE
❑ NEW SERVICE: ❑ Overhead ❑Underground ❑Underground up Pole
Residential (Main)Service:
0-100 amps i101-150amps ❑151-200amps ❑ amps #of Meters
_Commercial (Main)Service:
Lj0-100 amps ❑101-150amps ❑151-200amps ❑ amps ❑CT Service amps
Conductor Type Size
❑Multi-Family(Main)Service:
❑0-100 amps E101-150amps ❑151-200amps ❑ amps #of Unit Meters
❑ TEMPORARY POLE: amps
SERVICE UPGRADE: ❑ amps ❑CT Service amps
❑ NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.):
Z
100 amps ❑150amps _:200amps _ amps ❑CT Service amps
DITIONS, 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 )a
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 Ch nge. ❑OH to UG
❑Other: Qil01i,« �lC3a r, ) �!?r. upaoreaio/i�/is
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: �^ �'�� tr l Phone Number: 5 Q
Electrical Company: �1p\e,' �� 2,�rri..) Jtw IL�� Office Phone: ��� �7 - ).—] Fax: Z
Co.Address: �) Cio JJ 5�(� City: • -.a[v }1t w State: )'-L.Zip:
License Holder: State Certification/Registration#: c �'o f p)
c
Notarized Signature of License Holder c)� >
The foregoing instrument was acknowledged before me thi,$I _day o 262 a ate of FI ida,County of U c`
Signature of Notary Public
TONI GINDLESPERGER
MY COMMISSION#GG 353178 [ ] Personally Known OR[ ] Produced Identification
EXPIRES:October 6,2023 Type of Identification:
SPF f°�= Bonded Thry Notary Public Underwriters