5103 POLARIS CT ERES23-0109 S
S1-eill ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
Y s, ERES23-0109
CITY OF ATLANTIC BEACH
K. 800 SEMINOLE ROAD ISSUED: 5/11/2023
`''3»r v ATLANTIC BEACH. FL 32233 EXPIRES: 11/7/2023
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:
5103 POLARIS CT ELECTRICAL RESIDENTIAL ELECTRIC FOR REMODEL $2450.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
169397 0200 SECTION LAND
COMPANY: ADDRESS: CITY: STATE: ZIP:
BARKOSKIE ELECTRICAL JACKSONVILLE
953 Shetter Ave FL 32250
SERVICE BEACH
OWNER: ADDRESS: CITY: STATE: ZIP:
NAVAL CONTINUING CARE
RETIREMENT 1 FLEET LANDING BLVD ATLANTIC BEACH FL 32233-4599
FOUNDATION INC
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 APPLIANCES FIXED OR STATIONERY 455-0000-322-1000 0 $4.00
ELEC LIGHTING OUTLETS,INCLUDING FIXTURES 455-0000-322-1000 28 $16.80
ELECTRICAL BASE FEE 455-0000-322-1000 0 $55.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
Issued Date:5/11/2023 1 of 2
„,3'L'1iJr
Electrical Permit Application "ALL INFORMATION
HIGHLIGHTED IN
f
'” City of Atlantic Beach Building Department GRAY IS REQUIRED.
7.'V
far 800 Seminole Rd, Atlantic Beach, FL 32233 E.SE Sz 3 --0I c9
ii'•) ' Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: gt-5 xdr 0086
JOB ADDRESS: 5763 ,2)L 4€-/5 6PROJECT VALUE$ Z457U
JEA INFORMATION REQUIRED ON ALL PERMITS: /--IP AMPS ' J' VOLTS / PHASE
® NEW SERVICE: ❑Overhead ❑Underground ['Underground up Pole
O Residential(Main)Service:
00-100 amps 0101-150amps 1:1151-200amps 0 amps #of Meters
O Commercial(Main)Service:
❑0-100 amps 0101-150amps 0151-200amps 0 amps OCT Service amps
Conductor Type Size
OMulti-Family(Main)Service:
DJ-100 amps 0101-150amps 10151-200amps ❑ amps #of Unit Meters
❑TEMPORARY POLE: amps
El SERVICE UPGRADE:❑ amps OCT Service amps
❑ NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES, ETC.):
❑100 amps 0150amps 171200amps 0 amps al-Service amps
[21 ADDITIONS, REMODELS, REPAIRS, BUILD-OUTS,ACCESSORY STRUCTURES, ETC:
Outlets/Switches: (Z. 0-30amps 31-100amps 101-200amps
Appliances: 0-30amps I 31-100amps 101-200amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures: /40
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 OSafety Inspection [Panel Change DOH to UG
[lather:
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. �nS D t,4 ` A >Z �/
Owner Name: �� L C Phone Number: Z tet"G - .79 CJ CJ
Electrical Company: Barkoskie Electric Service Office Phone: (904)248-4731 Fax:(904)249-8017
Co.Address: 953 Shetter Avenue City: Jacksonville Beach State: FL Zip: 32250
License Holder: James Hughes State Certification/Registration#: EC13002387
Notarized Signature of License HolderAL11 —
�)
. MARGARET
The foregoing instrument was acknowledg d before me this /( day of v),447--,,20 2. in t(h/eJState of Florida,County of �Po.4 C
zl : iOA-MAY Signature of Notary Public— l/A a,
•: :+ MY COMMISSION I{GG 979259
:?;� ,: EXPIRES:July24,2024 [ 1 Personally Known OR[ 1 Produced I tification
2t BondedTfxuNolafyP�icUndelwlrer: Type of Identification:
- r. ..--- iii