1941 Seminole Rd ERES23-0065 COAB Permit Form with ConditionsOWNER:ADDRESS:CITY:STATE:ZIP:
LUCAS DAVID O 1941 SEMINOLE RD ATLANTIC BEACH FL 32233-5917
COMPANY:ADDRESS:CITY:STATE:ZIP:
STUART JONES ELECTRIC
INC.6334 Philips Hwy #103 JACKSONVILLE FL 32216
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
169542 0520 BEACHSIDE
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
1941 SEMINOLE RD ELECTRICAL RESIDENTIAL ELECTRIC FOR KITCHEN
REMODEL $2000.00
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
ELEC APPLIANCES FIXED OR STATIONERY 455-0000-322-1000 0 $4.00
ELEC LIGHTING OUTLETS, INCLUDING FIXTURES 455-0000-322-1000 20 $12.00
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
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: 3/27/2023
PERMIT NUMBER
ERES23-0065
ISSUED: 3/27/2023
EXPIRES: 9/23/2023
ELECTRICAL RESIDENTIAL PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
TOTAL: $75.00
2 of 2Issued Date: 3/27/2023
PERMIT NUMBER
ERES23-0065
ISSUED: 3/27/2023
EXPIRES: 9/23/2023
ELECTRICAL RESIDENTIAL PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
S vL`!r/r;
r,
Electrical Permit Application ALL INFORMATION
g HIGHLIGHTED IN
City of Atlantic Beach Building DepartmentC
GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 RE-S23-00
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: Z3 a 97
JOB ADDRESS: / ' `/ f -C-e.-it- -L,L:/. PROJECT VALUE$ 2 D do
JEA INFORMATION REQUIRED ON ALL PERMITS:2cob AMPS 2/6 VOLTS ( PHASE
NEW SERVICE: E Overhead Underground Underground up Pole
Residential (Main)Service:
0-100 amps o101-150amps o151-200amps amps of Meters
Commercial (Main)Service:
0-100 amps D101-150amps 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 CT Service amps
ADDITIONS, REMODELS, REPAIRS, BUILD-OUTS,ACCESSORY STRUCTURES, ETC:
Outlets/Switches: /0 0-30amps 31-100amps 101-200amps
Appliances: 2- 0-30amps 31-100amps 101-200amps
A/C Circuits:0-60amps 61-100amps
Heat Circuits:circuits @ kw
Number of Lighting Outlets, Including Fixtures: /c'
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 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.
Owner Name: L u c c S Phone Number:
Electrical Company: .. v 4rx-r- 1.--) 1,-1...cif.-'
t... Office Phone: !o 9 - 796- O/1/ Fax:
Co.Address: 2-2- 3 / - 3 6,,,-f S7 3/.J 3 2 2/C City: -Tc c CS 0-4 v, I(4 State: / f Zip: 3 2-2- I
License Holder: Si u M 2T- `- a .r.s State Certification/Registration#: FC 1 .Ob 3 2-7(
Notarized Signature of License Holder i%
i r"' (/
The foregoing instrument was acknowledged before me thi-" day of 11971i0 State of Florida,County of V- t 1/ (
Signature of Notary Public I,
TONI GINDLESPERGER
A, : : MY COMMISSION#GG 353178 [ ] Personally Known OR[ ] Prod d Identification
EXPIRES:October 6,2023 Type of Identification:
FO°,.° Bonded Thru Notary Public Underwriters