1823 SELVAA GRANDE DR ERES23-0029 - S'`'' ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
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CITY OF ATLANTIC BEACH ERES23-0029
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" ISSUED: 2/21/2023
800 SEMINOLE ROAD
--40;i19%.' ATLANTIC BEACH. FL 32233 EXPIRES: 8/20/2023
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.
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:
1823 SELVA GRANDE DR ELECTRICAL RESIDENTIAL ELECTRIC FOR REMODEL $30000.00
AND ADDITION
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
169542 5038 SELVA TIERRA
COMPANY: ADDRESS: CITY: STATE: ZIP:
PHASE ONE ELECTRIC LLC 2036 MAYPORT RD JACKSONVILLE FL 32233
OWNER: ADDRESS: CITY: STATE: ZIP:
SADOSKY LINDSEY NICOLE 1823 SELVA GRANDE DR ATLANTIC BEACH FL 32233-4526
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.
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
ELEC REPAIRS AND MISC 455-0000-322-1000 0 $35.00
ELEC SERVICE CHANGE 455-0000-322-1000 200 $50.00
ELECTRICAL BASE FEE 455-0000-322-1000 0 $55.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.10
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$144.10
Issued Date: 2/21/2023 1 of 2
Electrical Permit Application **ALL INFORMATION
�; HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 ARES" Z 3-�
'~ Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT as
JOB ADDRESS: i 0 oZ3 T e1U G, G( c de_. Dc PROJECT VALUE$ '301000
JEA INFORMATION REQUIRED ON ALL PERMITS:0200 AMPS J€ VOLTS ) PHASE
7,1 NEW SERVICE: ❑ Overhead ❑Underground ❑Underground up Pole 1 j\j CL ( Cj 0 I c ZOO
❑Residential (Main)Service: m
❑0-100 amps o101-150amps ` 151-200amps ❑ amps #of Meters
❑Commercial(Main)Service:
❑0-100 amps o101-150amps o151-200amps ❑ amps ❑CT Service amps
Conductor Type Size
❑Multi-Family(Main)Service:
❑0-100 amps o101-150amps o151-200amps ❑ amps #of Unit Meters
❑ TEMPORARY POLE: amps
❑ SERVICE UPGRADE: ❑ amps ECT Service amps
❑ NEW FEEDER (ADDITIONS,ACCESSORY STRUCTURES, ETC.):
❑100 amps ❑150amps ❑200amps ❑ amps ECT Service amps
Ix ADDITIONS, REMODELS, REPAIRS, BUILD-OUTS,ACCESSORY STRUCTURES, ETC:
Outlets/Switches: 40 0-30amps iili 31-100amps 101-200amps
Appliances: 0-30amps 0,2 31-100amps 101-200amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures: Sv
❑ OTHER ELECTRICAL PROJECTS:
❑Swimming Pool ❑Sign ❑Smoke Detectors (Qty) ❑Transformers KVA ❑Motors HP
n FIRE ALARM SYSTEM (Requires 3 sets of plans):
Qty volts/amps
❑ REPAIRS/MISCELLANEOUS:
❑Replace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change DOH to UG
❑Other: 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. 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. 0It; _ _ �
Owner Name: , — -� " 0IcO\e- (4o10sPhone Number: go 11-0? ()-- a63
Electrical Company:p y: PIAc-�&_, Qt\e, Ele,C'��( , LLC.. Office Phone: Qdy' Fax:
Co.Address: 203CP (1 4Q y pock ?--c City: -5-1AX( State: Pi Zip: . 223-3
License Holder: aC ,'\ ! ;RC& State Certification/Registration#: GC. )4oc) 53 S 0
AP-
Notarized Signature of License Holder moi` —
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The foregoing instrument was acknowledged before me this._ day of'` " a %S: State of Florida,County of A •
Y►' TONI GINDLESPERGER Signature of Notary Public _9 _ .�
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t . , MY COMMISSION#GG 353178
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Tyrfersonally Known ORE ] Produced Identification
;•�. , ro EXPIRES:October 6,2023
Type of Identification:
''',,F:'°''' Bonded T!xu Notary Public Underwriters