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1869 SEA OATS DR ERES23-0273 COAB Permit Form with ConditionsOWNER:ADDRESS:CITY:STATE:ZIP: KLEIN KARL M 1869 SEA OATS DR ATLANTIC BEACH FL 32233 COMPANY:ADDRESS:CITY:STATE:ZIP: Lumio HX Inc 1550 W. Digital Drive Suite 500 Lehi UT 84043 TYPE OF CONSTRUCTION: REAL ESTATE NUMBER:ZONING:BUILDING USE GROUP:SUBDIVISION: 172020 0538 SELVA MARINA UNIT 09 JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK: 1869 SEA OATS DR ELECTRICAL RESIDENTIAL Electrical connections for new Solar Panels $12151.20 FEES DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT ELEC REPAIRS AND MISC 455-0000-322-1000 0 $35.00 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 TOTAL: $94.00 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: 11/9/2023 PERMIT NUMBER ERES23-0273 ISSUED: 11/9/2023 EXPIRES: 5/7/2024 ELECTRICAL RESIDENTIAL PERMIT CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 2 of 2Issued Date: 11/9/2023 PERMIT NUMBER ERES23-0273 ISSUED: 11/9/2023 EXPIRES: 5/7/2024 ELECTRICAL RESIDENTIAL PERMIT CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 Electrical Permit Application **ALL INFORMATION HIGHLIGHTED IN GRAY IS REQUIRED.City of Atlantic Beach Building Department 800 Seminole Rd, Atlantic Beach, FL 32233 Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT #: __________________ JOB ADDRESS: ______________________________________________ PROJECT VALUE $_____________________ JEA INFORMATION REQUIRED ON ALL PERMITS: ______AMPS _____ VOLTS _____ PHASE NEW SERVICE: ප Overhead ෺Underground ෺Underground up Pole පResidential (Main) Service: පϬ-100 amps ප101-150amps පϭϱϭ-200amps ප_______amps # of Meters ______ පCommercial (Main) Service: පϬ-100 amps පϭϬϭ-150amps පϭϱϭ-200amps පͺͺͺͺͺͺͺĂŵƉƐ පCT Service ______ amps Conductor Type_________________ Size _______________ පMulti-Family (Main) Service: ප0-100 amps පϭϬϭ-150amps පϭϱϭ-200amps ප_______amps # of Unit Meters ______ TEMPORARY POLE: _______amps SERVICE UPGRADE: ප_______amps පCT Service ______ amps NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.): පϭϬϬĂŵƉƐපϭϱϬĂŵƉƐපϮϬϬĂŵƉƐපͺͺͺͺͺͺͺĂŵƉƐපCT Service ______ amps ADDITIONS, REMODELS, REPAIRS, BUILD-OUTS, ACCESSORY STRUCTURES, ETC: Outlets/Switches: _______0-30amps _______31-100amps _______101-200amps Appliances: _______0-30amps _______31-100amps _______101-200amps A/C Circuits: _______0-60amps _______61-100amps Heat Circuits: _______ # circuits @_______kw Number of Lighting Outlets, Including Fixtures: _______ OTHER ELECTRICAL PROJECTS: ප^ǁŝŵŵŝŶŐWŽŽůප^ŝŐŶප^ŵŽŬĞĞƚĞĐƚŽƌƐͺͺͺͺ___ (YƚǇͿපdƌĂŶƐĨŽƌŵĞƌƐͺͺͺͺͺͺͺͺͺ<sපMotors ______ͺ,W FIRE ALARM SYSTEM (Requires 1 set of digital plans): Qty _________ volts/amps ____________ REPAIRS/MISCELLANEOUS: පReplace Burnt/DĂŵĂŐĞĚDĞƚĞƌĂŶප^ĂĨĞƚǇ/ŶƐƉĞĐƚŝŽŶපWĂŶĞůŚĂŶŐĞපOH to UG පOther:__Electrical connections for new Solar Panels_____________________________________________________________________________U_pdate____d 10___/11/___23 __ WĞƌŵŝƚďĞĐŽŵĞƐǀŽŝĚŝĨǁŽƌŬdoes 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: _________ _______ WŚŽŶĞEƵŵďĞƌ: Electrical Company: KĨĨŝĐĞWŚŽŶĞ: ___ Fax: Co. Address: City: State: Zip: License Holder: ____________ State Certification/Registration #: Notarized Signature of License Holder The foregoing instrument was acknowledged before me this _____day of ___________, 20___, in the State of Florida, County of __________ ^ŝŐŶĂƚƵƌĞŽĨEŽƚĂƌǇWƵďůŝĐ ΀΁WĞƌƐŽŶĂůůǇ<ŶŽǁŶKZ΀΁WƌŽĚƵĐĞĚ/ĚĞŶƚŝĨŝĐĂƚŝŽŶ Type of Identification: ______________________________________________________________ 1 CODY ORAM / LUMIO HX INC 1550 W DIGITAL DRIVE #500 LEHI UT 84043 EC13006740 407-819-4000 1869 SEA OATS DR Atlantic Beach FL 32233 12,151.20 240200 (904) 386-0206 Jacksonville Electric Authority KLEIN KARL M 07 NOVEMBER 23 ORANGE ERES23-0273 X X DESCRIPTION ACCOUNT QTY PAID PermitTRAK $94.00 ERES23-0273 Address: 1869 SEA OATS DR APN: 172020 0538 $94.00 ELECTRICAL $90.00 ELECTRICAL BASE FEE 455-0000-322-1000 0 $55.00 ELEC REPAIRS AND MISC 455-0000-322-1000 0 $35.00 STATE SURCHARGES $4.00 STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00 STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00 TOTAL FEES PAID BY RECEIPT: R25447 $94.00 Printed: Thursday, November 9, 2023 8:57 AM Date Paid: Thursday, November 09, 2023 Paid By: Lumio HX Inc Pay Method: CREDIT CARD 10115846733 1 of 1 Cashier: TG Cash Register Receipt City of Atlantic Beach Receipt Number R25447