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Permit Bath Remodel 598 Clippership 2011 Vp CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5826 4. 4 ort19"4' Application Number 11- 00001941 Date 4/22/11 Property Address 598 CLIPPERSHIP LN Application type description RESIDENTIAL ALTERATION Property Zoning TO BE UPDATED Application valuation . . . 7800 Application desc remodel bath Owner Contractor YEAKEL, GLENN JEP CONTRACTORS INC 598 CLIPPERSHIP LANE 1416 FOREST AVENUE ATLANTIC BEACH FL 32233 NEPTUNE BEACH FL 32266 (904) 247 -9525 Permit PLUMBING PERMIT Additional desc . INSTALL 4 NEW FIXTURES Sub Contractor . CELTIC CUSTOM PLUMBING INC. Permit Fee . . . 83.00 Plan Check Fee . . .00 Issue Date . . . Valuation . . . . 0 Expiration Date . 10/19/11 Special Notes and Comments *2007 FLORIDA BUILDING CODE W/2009 REVISIONS NATIONALELECTRIC CODE *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. Other Fees STATE PLBG DCA SURCHARGE 2.00 STATE PLBG DBPR SURCHARGE 2.00 Fee summary Charged Paid Credited Due Permit Fee Total 83.00 83.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.00 4.00 .00 .00 Grand Total 87.00 87.00 .00 .00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. PLUMBING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach, FL 32233 p / Ph (904) 247 -5826 Fax (904) 247 -5845 /� ` JOB ADDRESS: S C\ O 4-\ �WQ ..C'∎� c��, t C� 'c 1 Kl.,1 -133 PERMIT #1 1" I 14- NEW OR REPLACEMENT INSTALLATION: Project Value $ 1 ) <> TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY Bathtub Septic Tank & Pit Clothes Washer Shower Dishwasher Shower Pan 1 Drinking Fountain Slop Sink Floor Drain Three Compartment Sink Floor Sink Toilet 1 Hose Bibs Urinal Kitchen Sink Vacuum Breakers Laundry Tray Water Connected Appliances Lavatory 1 Water Heater Other Fixtures Water Treating System RE -PIPE: TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY Bathtub Septic Tank & Pit Clothes Washer Shower Dishwasher Shower Pan Drinking Fountain Slop Sink Floor Drain Three Compartment Sink Floor Sink Toilet Hose Bibs Urinal Kitchen Sink Vacuum Breakers Laundry Tray Water Connected Appliances Lavatory Water Heater Other Fixtures Water Treating System MISCELLANEOUS: ❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor (Trap) gallons (Requires 3 sets of plans) ❑ Lawn Sprinkler System - Number of Heads ❑ Well * * ** SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection. ** ❑ Other 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. Property Owners Name ` Phone Number Plumbing Company c�C.r\ \,___ (_L . %- . \.�`� Office Phone r 3 ° ' c b7S1 Fax Co. Address: 1 -t1 -f 6 — <(.. �c &( �x= �A 'I --`3` it , a ` ot... \ Stated 1, Zip`11 1 License Holder (Print): C_,LS `5 N,. State Certification/Registration # C'FL \ L- ff'2 -`f `J Notarize Si, nature of License Holde � . 4 r ' DE 1 rn and subscribed before • , this c day of ■ 20 7/ w. i'i :* MY COMMISSIO # DD / / d vie BondedThuN ExPrllo Ma 126 n at u re o f N otary P u b lic °�N P Undn»iters �� - U/( 0 y = e CITY OF ATLANTIC BEACH ,��� 800 SEMINOLE ROAD ,r- 0 ATLANTIC BEACH, FL 32233 -. INSPECTION PHONE LINE 247 -5826 Application Number 11- 00001941 Date 4/22/11 Property Address 598 CLIPPERSHIP LN Application type description RESIDENTIAL ALTERATION Property Zoning TO BE UPDATED Application valuation . . . 7800 Application desc remodel bath Owner Contractor YEAKEL, GLENN JEP CONTRACTORS INC 598 CLIPPERSHIP LANE 1416 FOREST AVENUE ATLANTIC BEACH FL 32233 NEPTUNE BEACH FL 32266 (904) 247 -9525 Permit PLUMBING PERMIT Additional desc . INSTALL 4 NEW FIXTURES Sub Contractor . CELTIC CUSTOM PLUMBING INC. Permit Fee . . 83.00 Plan Check Fee . . .00 Issue Date . . . Valuation . . . . 0 Expiration Date . 10/19/11 Special Notes and Comments *2007 FLORIDA BUILDING CODE W/2009 REVISIONS NATIONALELECTRIC CODE *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. Other Fees STATE PLBG DCA SURCHARGE 2.00 STATE PLBG DBPR SURCHARGE 2.00 Fee summary Charged Paid Credited Due Permit Fee Total 83.00 83.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.00 4.00 .00 .00 Grand Total 87.00 87.00 .00 .00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. PLUMBING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach, FL 32233 Ph (904) 247 -5826 Fax (904) 247 -5845 ,/� , JOB ADDRESS: c c�p�C` .� ` -akN t ` e ,<., � r k1.� 12`01 PERMIT #1 \" l p l4\ NEW OR REPLACEMENT INSTALLATION: Project Value $ I ) c30'. TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY Bathtub Septic Tank & Pit Clothes Washer Shower Dishwasher Shower Pan 1 Drinking Fountain Slop Sink Floor Drain Three Compartment Sink Floor Sink Toilet Hose Bibs Urinal Kitchen Sink Vacuum Breakers Laundry Tray Water Connected Appliances Lavatory 1 Water Heater Other Fixtures Water Treating System RE -PIPE: TYPE OF FIXTURE QTY TYPE OF FIXTURE QTY Bathtub Septic Tank & Pit Clothes Washer Shower Dishwasher Shower Pan Drinking Fountain Slop Sink Floor Drain Three Compartment Sink Floor Sink Toilet Hose Bibs Urinal Kitchen Sink Vacuum Breakers Laundry Tray Water Connected Appliances Lavatory Water Heater Other Fixtures Water Treating System MISCELLANEOUS: ❑ Sewer Replacement ❑ Back Flow Preventer ❑ Grease Interceptor (Trap) gallons (Requires 3 sets of plans) ❑ Lawn Sprinkler System - Number of Heads ❑ Well ** ** SJRWD Well Completion Form. Completed form to be submitted to the Building Department for final inspection. ** ❑ Other 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. Property Owners Name ` Phone Number Plumbing Company CSC.. \'\c �Q •■ % v ‘Vc- Office Phoneqthk r §'\ :1"/S :1"/S , Fax Co. Address: L kL 6 •- W', NQ„t\�r <`S \ -X`` 'G`3 ity -- Co , `s°t.J \ \`z- State�ll. Zip License Holder (Print): C�c ‘--S o t" State Certification/Registration # (...,f(- I I-RI T3 e Notarize Si : nature of License Holde / ` 2 0 rt. oE _ • rn and subscribed before this day of (/ aoRa0a.7011E y t / / C MY COMMISSION � pD 634f 26 � '' EXPIRES: 4tay2t 2 010 S _nature of Notar Public i °f,1. 'O =Wed Thru Notary Public Underwriters 0 - 0/( 0 r'S 1 !y% -L`I Try 4 r Ai e C x CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5826 i .. .;.M X31 9 Application Number 11- 00001941 Date 4/20/11 Property Address 598 CLIPPERSHIP LN Application type description RESIDENTIAL ALTERATION Property Zoning TO BE UPDATED Application valuation . . . 7800 Application desc remodel bath Owner Contractor YEAKEL, GLENN JEP CONTRACTORS INC 598 CLIPPERSHIP LANE 1416 FOREST AVENUE ATLANTIC BEACH FL 32233 NEPTUNE BEACH FL 32266 (904) 247 -9525 Permit RESIDENTIAL ALT /OTHER Additional desc . Permit Fee . . . 90.00 Plan Check Fee . . 45.00 Issue Date . . . Valuation . . . . 7800 Expiration Date . 10/17/11 Special Notes and Comments *2007 FLORIDA BUILDING CODE W/2009 REVISIONS NATIONALELECTRIC CODE *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. Other Fees STATE DCA SURCHARGE 2.00 STATE DBPR SURCHARGE 2.00 Fee summary Charged Paid Credited Due Permit Fee Total 90.00 90.00 .00 .00 Plan Check Total 45.00 45.00 .00 .00 Other Fee Total 4.00 4.00 .00 .00 Grand Total 139.00 139.00 .00 .00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. t BUILDING PERMIT APPLICATION CITY OF ATLANTIC BEACH . 800 Seminole Road, Atlantic Beach, FL 32233 • Office (904) 247 -5826 Fax (904) 247 -5845 Job Address: „ 9 T 6/fpr 6A I , Permit Number: h % I/ 1 Legal Description35 ' 4 ' -1 7-- 25 - Z 9 E pricy Parcel # Floor Area of q.li' . Sq.Ft Valuation of Work $ -7 �e.?L Proposed Work heated /cooled / I A®/ non - heated/cooled S--7 Class of Work (circle one): New Addition teration7Repair Move Demolition pool/spa window /door Use of existing /proposed structure(s) (circle one): Commercial Reside ' If an existing structure, is a fire sprinkler system installed? (Circle one)`. es 1 0 N /A Florida Product Approval # For multiple products use product approva oT rf m Describe in detail the type of work to be performed: re-W.4 le-( bL7th,'m; he (✓ A PVl f,51 1 I .alt' 1' ..1 ...-----. ' wa ' r perty Owner Information: Name: fe y �G `1C . Address: Si $ (�1 J�r 7 O • Lcu._ AAA City , � St PL Zip 312 Phone (Roy) a'i1- (9.7.17 E -Mail or Fax # (Optional) (a Ie i n y 3 (9 (-trim/mot • net' Contractor Information: dd Company N �,e: J E • o ra 6 r5 in e. Qualifyin Agent: J n ,e r rso 1 Address: t `f /. FP re 51 J V� ty vtie- l e k State FL Zip 3�y4L Ci � Dffice Phone 9oc.-i' 2-4- 7 95t Job Site/ Contact Number z. -- 6 g 3 Z Fax # 0 7- l p State Certification/Registration # C6e; ©s 6 ' 4 Architect Name & Phone # et r4 1 , ti , S r Engineer's Name & Phone # . ` Fee Simple Title Holder Name and Addres .�1► _ ,� -� : _ , _ , _� ... _ r • .: t 3onding Company Name and Address e io Mortgage Lender Name and Address - , - �� R�yy. DATE 1pplication is hereby made to obtain a permit to do the work and installations as indic. - �c �t�zaT no work • - -- -- he ssuance of a permit and that all work will be performed to meet the standards of all law L_ -, -- -;^^""" , . ' is permit becomes null znd void ifwork is not commenced within six (6) months, or if construction or work is suspended or abandoned fora period of six 6) months at any time after vork is commenced I understand that separate permits must be secured for Electrical Work, Plumbing, S Wells, Pools, F urnaces, Bo Heaters, ranks and Air Conditioners, etc. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FlN 4NC '-' CONSbT TITH YOUR LENDER OR AN ATTORNEY BEFORE RECO ' 1, ' ..1 if ` it ° F COM ENCEMENT. i.� �1 V 4, hereby certify that have read and examined this a placation and know the same to be true and correct. 4' ' provisions o aws az ordinanc -- overning this ype of work will be complied with whether specified herein or not. The granting of a permit does n.r - , - , - r cancel the Provisions of any other federal, state, or local law regulating construction or the performance ofconstruc''. ,- ,, .,...:..,. .�,..-- ,,, >ignature of Owner / ViCiAiU Signature of Contractor • 'riot Name &INC% +l e, i Print Name 6 E , r„ I p vt worn to and subscribed before me Sworn to .nd subscribed before me his S } "A Day of A ,`, NO \ , 20 k , this _ .' . r r • SWIM ■ lotary Publ'c Notary r s i �'' AM 957760 Z „ � a ar Pk, Notary Public State of Florida * ' CrY� I '� � o * EXP I' S: Febr ' . '4 01.26.10 Sharon P Smith 1 ��t(y �%Rf,Ath` ' Bonded Thru Notary Public Unie7wn{ers 9 - ,s My Commission DD668827 of rO 4 Expires 05/05/2011 PV rS Y 'I.Y' City of Atlantic Beach APP LICATI ON NUMBER s " o be assi fi ned th Building D artm Building Department Cr 9 s p ) S1 41 S 41 4 '_ y 800 Seminole Road r r �4F ' Atlantic Beach, Florida 32233 -5445 - _ ; ' Phone (904) 247 -5826 • Fax (904) 247 -5845 . F .- --r ;t FY"' E -mail: building - dept @coab.us Date rou i „ F� City web -site: http: / /www.coab.us t APPLICATION REVIEW AND TRACKING FORM p Property Address: `8 � � //0 L � D ent review required Yes No �� Building Applicant: licant: c P CI1TCI-crZJ e s r unning & Zoning Tree Administrator Project: ill nd t L _ f,... Public Works *----Y) t 4- / _S Public Utilities Public Safety Fire Services ee za s rs + , s s r - gin 14 w a ''''' view fe&.4 ,i X 1 1 ,,, 1 - 14„_ DeP 4 ? atr r _ ... .a . s Other Agency Review or Permit Required Review or Receipt Date of Permit Verified By Florida Dept. of Environmental Protection Florida Dept. of Transportation St. Johns River Water Management District Army Corps of Engineers Division of Hotels and Restaurants Division of Alcoholic Beverages and Tobacco Other: APPLICATION STATUS Reviewing Department First Review: ®Approved. ['Denied. (Circle one.) Comments: BUILDING PLANNING & ZONING Reviewed by: 17 Date: e i'/ 9 TREE ADMIN. Second Review: ['Approved as revised. ❑Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by: Date: FIRE SERVICES Third Review: ['Approved as revised. UDenied. Comments: • Reviewed by: Date: Revised 05/14/09 NOTICE OF COMMENCEMENT State of FC— Tax Folio No. - County of by ✓tt 1 To Whom It May Concern: The undersigned hereby informs you that improvements will be made to certain real property, in accordance with Section 713 of the Florida Statutes, the following information is stated in this NOTICE OF COMMENCEMENT. Legal description of property being improved: ...7-. - et 17 25 Z gE ���p ,, y 62 3 `VS — S Address of property being improved: 59g %I,1 ��sti: p L - ,4,. .�f la. i- < 6e GL e , #z 7.---.1# 3 General description of improvements: (h e rfar- re n-.�.I eI, :i . L er: 1 Z if�a� t- _ , Addr ess: ' : .' _- - ' - I' "411r. PL . 2 er's interest in site of ' t1; i provement Simple Titleholder (if other than owner): e: � ddress: Contractor: i - EP • • (:.mob -) f r-'€:.faw s, /PVC- Address: /we, i t",,. i- t- . y&. - A r fv . v', e.acJ' . FA- 3 -z-2e6 41 Phone No: q --- 247 - 95'z -s' Fax No: ,e)'-1 - Z 7 - /! Ve Surety (if any): '' Address: ) Amount of Bond $ " Fax No: Phone No: Name and address of any person making a loan for the construction of the improvements. Name: Address: / kJ • Phone No: // Fax No: Name of person within the State of Florida, other than himself, designated by owner upon whom notices or other documents may served: Name: - Address: Phone No: Fax No: In addition to himself owner designates the following person to receive a copy of the Lienor's Notice as provided in _ Section 713.06(2)(b), Florida Statues. (Fill in at-Owner's option). — Name: Address: Phone No: ( Fax No: Expiration date of Notice of Commencement (the expiration date is one 1) year from the date of recording unless a different date is specified): iv 1 o THIS SPACE FOR RECORDER'S USE ONLY E Signed: `i L Date: ` -- 5 Before me this "rh ay of F'`p r � 1 i 2D 11 in the County =O 4.0 INs, Notary Public State of Florida *, of Duval, State of Florida, as personally appeared Sharon P Smith % 2.� 1� *f._ .. ? , o My Commission DD668827 y } "'oi fe Expires 05105/2011 Notary Public at Large, State of Florida, County of Duval. My commission expires: .5‘o s \ k-1 Doc # 2011084959, OR BK 155 Page 428, Personally Known: ,r- or Number Pages: 1 Produced Identification: Recorded 04'1512011 at 09:41 AM, JIM FULLER CLERK CIRCUIT COURT DUVAL COUNTY RECORDING $10.00 ,:,,,,. , , *.";$ , . j 1-A11:0 * S CITY OF ATLANTIC BEACH �. 800 SEMINOLE ROAD J s ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5826 P` Application Number 11- 00001941 Date 4/26/11 Property Address 598 CLIPPERSHIP LN Application type description RESIDENTIAL ALTERATION Property Zoning TO BE UPDATED Application valuation . . . 7800 Application desc remodel bath Owner Contractor YEAKEL, GLENN JEP CONTRACTORS INC 598 CLIPPERSHIP LANE 1416 FOREST AVENUE ATLANTIC BEACH FL 32233 NEPTUNE BEACH FL 32266 (904) 247 -9525 Permit ELECTRICAL PERMIT Additional desc . Sub Contractor . FIRST CHOICE ELECTRIC Permit Fee . . . 56.20 Plan Check Fee . . .00 Issue Date . . . Valuation . . . . 0 Expiration Date . 10/23/11 Special Notes and Comments *2007 FLORIDA BUILDING CODE W/2009 REVISIONS NATIONALELECTRIC CODE *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. Other Fees STATE ELEC DCA SURCHARGE 2.00 STATE ELEC DBPR SURCHARGE 2.00 Fee summary Charged Paid Credited Due Permit Fee Total 56.20 56.20 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.00 4.00 .00 .00 Grand Total 60.20 60.20 .00 .00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. ELECTRICAL PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd, Atlantic Beach, FL 32233 Ph (904) 247 -5826 Fax (904) 247 -5845 JOB ADDRESS: . f r,' C` .., N. _�� ' e , L ,--3 PERMIT # ? ± i JEA INFORMATION REQUIRED ON ALL PERMITS AMPS VOLTS PHASE VALUE OF WORK $ NEW SERVICE ❑ Overhead n Underground ❑J Underground up Pole ❑Residential (Main) Service ❑0 -100 amps ❑ 101- 150amps ❑ 151- 200amps ❑ amps # of Meters ❑ Commercial (Main) Service ❑0 -100 amps ❑ 101- 150amps ❑ 151- 200amps ❑ amps ❑CT Service amps Conductor Type Size ❑ Multi - Family (Main) Service 00 -100 amps ❑ 101- 150amps ❑ 151- 200amps ❑ amps # of Unit Meters ❑Temporary Pole ❑ amps SERVICE UPGRADE ❑ amps ❑ CT Service amps NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.) ❑ 100 amps ❑ 150amps 0200amps ❑ amps ❑CT 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: 1 } jG-.1 OTHER ELECTRICAL PROJECTS ❑ Swimming Pool ❑ Sign ❑ Smoke Detectors _Qty ❑Transformers KVA ❑ Motors hp FIRE ALARM SYSTEM (Requires 3 sets of plans & Fire Alarm Checklist) VALUE OF WORK $ Qty volts /amps REPAIRS/MISCELLANEOUS ❑Replace Burnt/Damaged Meter Can El Safety Inspection ❑Panel Change ❑ to UG • ❑ Other: 5 z, \ .. i`.: Yc =, 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. Property Owners Name Phone Number Electrical Company --E, 21 :1-. C-1, - is , ` � =- < .1 Office Phone - 7'' s i 'S Z 1 Fax Co. Address: , j::. a.,� i r;.j_. t' % - 1...J City `i.1 ' ' � � - 1 State -`.. Zip - �_y -- t ti State , , d lri # , :s I License Holder ( Print): c3- ‹�► i^. �', ..'. {= t ^� i r�ps5n Fl utl ... ,.— � � ;. �:� ' I_XPIR F�rr� 14 2014 Notarized Signature of License Holder �,. _,, _ sk:.. ,�•..ca . f -- " �' ° "4,,,i ff ° `° Bonded T i ■ . Sworn and subscribed be . •: 1e t is ' lay f A![ Di/ 20 `l 1 Signature of Notary Public., _.a , - —/ � ,� � j 1- ' '0 ,. C'' ; ti `s CITY OF ATLANTIC BEACH ,, .,• .0 800 SEMINOLE ROAD Oft, Z ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247 -5826 Application Number . . . . . 11- 00001941 Date 4/26/11 Property Address 598 CLIPPERSHIP LN Application type description RESIDENTIAL ALTERATION Property Zoning TO BE UPDATED Application valuation . . . 7800 Application desc remodel bath Owner Contractor YEAKEL, GLENN JEP CONTRACTORS INC 598 CLIPPERSHIP LANE 1416 FOREST AVENUE ATLANTIC BEACH FL 32233 NEPTUNE BEACH FL 32266 (904) 247 -9525 Permit ELECTRICAL PERMIT Additional desc . Sub Contractor . FIRST CHOICE ELECTRIC Permit Fee . . . 56.20 Plan Check Fee .00 Issue Date . . . Valuation . . . . 0 Expiration Date . 10/23/11 Special Notes and Comments *2007 FLORIDA BUILDING CODE w/2009 REVISIONS NATIONALELECTRIC CODE *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. Other Fees STATE ELEC DCA SURCHARGE 2.00 STATE ELEC DBPR SURCHARGE 2.00 Fee summary Charged Paid Credited Due Permit Fee Total 56.20 56.20 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 4.00 4.00 .00 .00 Grand Total 60.20 60.20 .00 .00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. ELECTRICAL PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd, Atlantic Beach, FL 32233 Ph (904) 247 -5826 Fax (904) 247 -5845 JOB ADDRESS: .9 e C i f--) i 1 .� ; / �, ' � - , ;77, L �.i PERMIT # ! '� JEA INFORMATION REQUIRED ON ALL PERMITS AMPS VOLTS PHASE VALUE OF WORK $ NEW SERVICE n Overhead n Underground DJ Underground up Pole :Residential (Main) Service ❑O -100 amps ❑ 101- 150amps ❑ 151- 200amps ❑ amps # of Meters :Commercial (Main) Service DO-100 amps ❑ 101- 150amps ❑ 151- 200amps ❑ amps ❑CT Service amps Conductor Type Size ❑ Multi- Family (Main) Service ❑ - 100 amps ❑ 101- 150amps ❑ 151- 200amps ❑ amps # of Unit Meters ❑ Temporary Pole ❑ amps SERVICE UPGRADE ❑ amps ❑ CT 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- 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: 1 }' OTHER ELECTRICAL PROJECTS ❑ Swimming Pool ❑ Sign ❑ Smoke Detectors Qty ❑ Transformers KVA ❑ Motors hp FIRE ALARM SYSTEM (Requires 3 sets of plans & Fire Alarm Checklist) Qty volts /amps VALUE OF WORK $ REPAIRS/MISCELLANEOUS ❑ Replace Burnt/Damaged Meter Can ❑ Safety Inspection ❑ Panel Change ❑ OH to UG C ❑ Other: 3 1 ., l 'v,.r._iZ: 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. Property Owners Name Phone Number i Electrical Company -- F 4. :T C.lr.s ; 'Iyl - Office Phone 7 `t /- 3. I Fax 1 Co. Address: ! 4 . i c '°' : ,� r r , J k.1 City ' '' t • - / Y.� _ � � State =�; _ Zip � �. _,__ � 1 6M1xry License Holder (Print): _,_.._.,•�_ s.A,��. , ; t.�, .,�t,t State , ; t10 ,( tr # e 'sr . - °-� Notarized Signature o � ,�u i' ISSN S r)D 957760 ure e Holder ' ------ ` ' • '` 1-e ■ E<. , 1 a2ota g f Licens Hld 1i _a,y..f:z. ` n (� t-- pF F ;,, Bonded T .. Sworn and subscribed be • e t is ' A ay f 40.11/1/ 201/ N. Signature of Notary Public... _ . . , ' ��I