1823 Selva Grande Dr ERES23-0029 COAB Permit Form with Conditions - Updated PermitOWNER:ADDRESS:CITY:STATE:ZIP:
SADOSKY LINDSEY NICOLE 1823 SELVA GRANDE DR ATLANTIC BEACH FL 32233-4526
COMPANY:ADDRESS:CITY:STATE:ZIP:
PHASE ONE ELECTRIC LLC 2036 MAYPORT RD JACKSONVILLE FL 32233
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
169542 5038 SELVA TIERRA
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
1823 SELVA GRANDE DR ELECTRICAL RESIDENTIAL
ELECTRIC FOR REMODEL
AND ADDITION & NEW
SERVICE 300 amps
$30000.00
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
ELEC SERVICE CHANGE 455-0000-322-1000 300 $90.00
ELECTRICAL BASE FEE 455-0000-322-1000 0 $55.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.10
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: 2/21/2023
PERMIT NUMBER
ERES23-0029
ISSUED: 2/21/2023
EXPIRES: 2/28/2024
ELECTRICAL RESIDENTIAL PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $234.10
2 of 2Issued Date: 2/21/2023
PERMIT NUMBER
ERES23-0029
ISSUED: 2/21/2023
EXPIRES: 2/28/2024
ELECTRICAL RESIDENTIAL PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
Electrical Permit Application ALL INFORMATION
HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 ARES" Z3-Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT as
JOB ADDRESS: i 0 oZ3 T e1U G, G( c de_. Dc PROJECT VALUE$ '301000
JEA INFORMATION REQUIRED ON ALL PERMITS:0200 AMPS J€ VOLTS ) PHASE
7,1 NEW SERVICE: Overhead Underground Underground up Pole 1j\j CL ( Cj 0 I c ZOO
Residential (Main)Service:
m0-100 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` 1
ww
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 _
r7' . •°;
t . , MY COMMISSION#GG 353178
f,,
Tyrfersonally
Known ORE ] Produced Identification
ro EXPIRES:October 6,2023
Type of Identification:
F:'°''' Bonded T!xu Notary Public Underwriters