568 Timber Bridge Lane ERES21-0006 COAB Permit Form with Conditions - RenewedOWNER:ADDRESS:CITY:STATE:ZIP:
ELIZABETH BISSELL LUCY
TRUST 568 TIMBER BRIDGE LANE ATLANTIC BEACH FL 32233
COMPANY:ADDRESS:CITY:STATE:ZIP:
HAZOURI ELECTRIC, INC.6142 Golden Oak Lane Keystone Heights FL 32656
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
169505 2135 ATLANTIC BEACH
COUNTRY CLUB UNIT 02
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
568 TIMBER BRIDGE LN ELECTRICAL RESIDENTIAL ELECTRIC FOR POOL -
Renewed $985.00
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
ELEC SWIMMING POOLS 455-0000-322-1000 0 $40.00
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: 1/11/2021
PERMIT NUMBER
ERES21-0006
ISSUED: 1/11/2021
EXPIRES: 3/30/2024
ELECTRICAL RESIDENTIAL PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
TOTAL: $99.00
2 of 2Issued Date: 1/11/2021
PERMIT NUMBER
ERES21-0006
ISSUED: 1/11/2021
EXPIRES: 3/30/2024
ELECTRICAL RESIDENTIAL PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
Electrical Permit Application ALL INFORMATION
f--
HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 E_ R I - 006
Phone: (904) 247-5826 Email: Bu_ ilding-Dept@coab.us PERMIT#: 2-0 -O 3(
JOB ADDRESS: 5I) / 71 -1_ci (' c- /.2.--i ,7 PROJECT VALUE $ 9,fj
JEA INFORMATION REQUIRED ON ALL PERMITS: 3') AMPS 2'1"VOLTS / PHASE
El NEW SERVICE: 0 Overhead Underground Underground up Pole
DResidential (Main)Service:
00-100 amps 0101-150amps 0151-200amps 0 amps of Meters
Commercial (Main)Service:
0-100 amps 0101-150amps 0151-200amps 0 amps OCT Service amps
Conductor Type Size
Multi-Family(Main) Service:
0-100 amps 0101-150amps 0151-200amps amps of Unit Meters
n TEMPORARY POLE: amps
SERVICE UPGRADE: amps OCT Service amps
n NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.):
0100 amps 0150amps D200amps 0 amps OCT Service amps
ADDITIONS, REMODELS, REPAIRS, BUILD-OUTS, ACCESSORY STRUCTURES, ETC:
Outlets/Switches: 0-30amps 31-100amps 101-200am ps
Appliances: 0-30amps 31-100amps 101-200amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits:circuits @ kw
Number of Lighting Outlets, Including Fixtures:
n OTHER ELECTRICAL PROJECTS:
Wwimming Pool['Sign Smoke Detectors Qty) Transformers KVA Motors HP
n FIRE ALARM SYSTEM (Requires 3 sets of plans):
Qty volts/amps
n REPAIRS/MISCELLANEOUS:
Replace Burgt/Damaged Meter Can Safety Inspection Panel Change DOH to UG
Jther: tt)i-,..- JU iJ L 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. J 331
Owner Name: /S ,- S S-L (- 3PhoneNumber: l - 12 /
Electrical Comp/
t `
anry //¢2ii/G lC h c[ /e c( (. Office Phone:
T C/ - 3 cl Fax:
Co.Address: Ol'1 f C C-4-- City: / >7Z.--c- State: A Zip:3 e-1/Z
i
License Holder: -- State Certification/Registration#: eCt 2CcJ 2`T
Notarized Signature of License Holder
ThegfaimmaiagissibumaisAawmaiclamosiledged before me this day of in the State of Florida, County of_(.
1 :.,;:ii oB-. CHO ROBERTS I y
Notary Public State of Florida Signature of Notary Public
1 iii if. Commission#GG 211925
9 .?'oFrJ'' My Comm.Expires Aug 21,2022 I
Bonded through National Notary Assn.