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408 Irex Rd 2013 ada renovations s, CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD j ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 J,3 � Application Number . . . . . 13-00003530 Date 10/21/13 Property Address . . . . . . 408 IREX RD Application type description RESIDENTIAL ALTERATION Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 60000 ---------------------------------------------------------------------------- Application desc GENERAL ADA RENOVATIONS --------------------------------------------------------------------------- Owner Contractor - ------------------------ ----------------------- ISLEY, JR. , RALPH SEDA CONSTRUCTION COMPANY 408 IREX ROAD 2120 CORPORATE SQ. BLVD. #3 ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32216 (904) 591-2723 --- Structure Information 000 000 GENERAL ADA RENOVATIONS Occupancy Type . . . . . . RESIDENTIAL --------------------------------------------------------------------- Permit . . . . . . RESIDENTIAL ALT/OTHER Additional desc . . Permit Fee . . . 320 . 00 Plan Check Fee 160 . 00 Issue Date . . . . Valuation . . . . 60000 Expiration Date . . 4/19/14 ------------------------------------------------------------------- Special Notes and Comments 2010 FLORIDA BUILDING CODE, 2008 NATIONAL ELECTRIC CODE *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. WINDOW AND DOOR INSPECTION: *INSTALLATION INSTUCTIONS REQUIRED *ALL STICKERS ARE TO REMAIN ON THE WINDOWS *PROVIDE ACCESS TO ALL WINDOWS TO INSPECT FASTENERS --------------------------------------------------------------- Other Fees . . . . . . . . . STATE DCA SURCHARGE 4 . 80 STATE DBPR SURCHARGE 4 . 80 ------------------------------------------------------------- Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---- Permit Fee Total 320 . 00 320 . 00 . 00 . 00 Plan Check Total 160 . 00 160 . 00 . 00 . 00 Other Fee Total 9 . 60 9 . 60 . 00 . 00 Grand Total 489 . 60 489 . 60 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. This Instrument Prepared BVD Name Address Permit,No. ax Folio No. NOTICE OF COMMENCEMENT S7AT=OF V COUNTY Or THE UNOERS)G NED hereby gives notice that improvement will be made to cerin real prupertp,and ir,a-ordance with Chapter 713,Fiorids Statutes,the foliowinc information is provided in tnis Notice of Commencement. 1.Descripvon o^ ro em' (le al oescrici or o`_pro ty,and et address F ayaila n� l ��`✓ .��i3✓'`� 2.Gen(raoescnitori gr ImprovIIemh/ent ;, r6 ' AC-.1J 'C� 33Dd 3.Owner information -TSfey a. Name and address: b. Interest in property: c. Name and address of fee simple titleholder(If other than owner): S(ja 4.Contractor: ✓Ut S y�/' n awl ( / a. Name and address: Ti��b. Phone number. -/f/ l T � �� Doc#2013264786,OR BK 16562 Page 1492, Number Pages:1 A 5.Surety Recorded 10:15/2013 at 01:17 PM, a Name and dress: Ronnie Fussell CLERK CIRCUIT COURT DUVAL b.Amount of bon COUNTY c. Phone number. RECORDING$10.00 6.Lender a. Name and dress: b. Phone numbe. 7.Persons within the State of Fiorida designated by Owner upon whom notices or other documents may be served as provided by Se ion 713.13(1)(a)%Florida Statutes: a. Name and ad ss: b. Phone number. 6.In addition,to himself,Owner designates the following person(s)to receive a copy of the Lienors Notice as provided in Section 713.13(1)(b),Florid. atutes: a. Name and address. b. Phone number. 9.Expiration date of notice of commencement(the expiration date is 1 year from the date of recording unless a different date is specified) WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE Ri=CORDrD AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEM514T. Sign�,umnfOwneir Owners Authorized Otnoer/Duvotor Partner/Manager Signatory's TitlelOffice regoing instrument was rknowiedged before me this„[L day of ": -,I--�11�(Year)by h i it (type of (name of person} as (name of party on aut rity, ...e.g. c stee, attorney in fact) for behalf of whom instrument was executed). . Signature of Notary Public–State gr r•ionca PublicPrint,Type,or Stamp Commissioned Name of Notary Commission Number Personally Known_oCP u^edIde- Verification ouisuant to Section 92.5-7r � da S�t`utes Under penalties o perjury, 1 declare that I have read the foregoing and that the facts stated ' `rRM# Znfa j L CL AL\/A{ EZ knowledge and belief. i .n lulY .",C LiMtSS10iV#-E131910 _ October lJl, 15 Sionature of Natural Parson Sign in F+ ,;ridallotctober 0corn (407)398- 153 rf.a�in City of Atlantic Beach APPLICATION NUMBER Building Department (To be assigned by the Building Deparbmnt) i 800 Seminole Road Atlantic Beach,Florida 32233-Ci445 end Phone(904)247-5826 Fax(904)247-5845 E-mail: building-dept@coab.us Date routed: d l(O City web-site: http://www.coab.us APPLICATION REVIEW AND TRACKING FORM Property Address: T�� 1.��X ent review required Ye No Building Applicant: 10 _ nning &Zoning // TT ,�[� Tree Adrninistiator Project: �rea-Z 14 U,4 ?�i✓0 V4%/ dWs Public Works Public Utilities Public Safety Fine Services Review fee $ Dept Signature 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: proved. ❑Denied. j (Circle one.) Comments: BUILDING PLANNING &ZONING Reviewed by: Dater TREE ADMIN. Second Review: DApproved as revised. ❑Denied. PUBLIC WORKS Comments: PUBLIC UTILITIES PUBLIC SAFETY Reviewed by. Date: FIRE SERVICES Third Review: ElApproved as revised. [Denied. Comments: Reviewed by: Date: Rarisert 05/14109 CITY OF ATLANTIC BEACH Building Department S� S) 800 Seminole Road Atlantic Beach,Florida 32233 (904)247-5800 PLAN REVIEW COMMENTS Permit Application # 13-- 3 5 30 Property Address: yO J' X rex 12ol, , Applicant: Seold ion S7/'uc lc)n Project: GenPrq /� ,d �enoyaJ'ia.� s This permit application has been: Approved Reviewed and the following items need attention: bn Proa�vc 7 r a� �'Ir�vl�a' �u►� � 7'��r.b 2 7�r a�var� ©kvi 'P l/r' sib rie h� v r '� e a � �ta S 1' hL h1 -4Aewi L) cPr -e s e tl ✓-ed PPCA- a f-GUa 1 # 2 00r— bu ' - s e"_0 ry -! IV U Please re-submit your application when these items have been completed. Reviewed By: _ 171 Date: 10417-1- BUILDING PERMIT APPLICATION 0, CITY OF ATLANTIC BEACH � COPY Atlantic Beach FL 32233 k ilt 800 Seminole Road, Office (904) 247-5826 Fax (904) 247-5845 , " Job Address: "l (Cly %33' Permit Number: /'Z— 3S_ 3d Legal Description Parcel # Fl oor Area ot Sq.Ft. Sq.Ft Valuation of Work$ d Proposed Work heated/cooled G non-heated/cooled A� Class of Work(circle one): New Addition Iteration Repair Move Demolition pool/spa nd Use of existing/proposed structure(s) circle one): Commercial esiden— t� 'r ( 0 If an existing structure,is a fire sprinkler system installed? (Circle one): es No N /A Florida Product Approval# 1,?7 VU '. For multiple products use product approval form / ert o Describe in detail the type of work to be performed: rle /�k / 4hSR r---" w � Property Owner Information: /f Name: h �s�� Address: vC City 3-e4c k State J G Zip 3 Phone - a E-Mail or Fax#(Optional) Contractor Information: A Company Name: G Cd'/'l b.C�G/(��1 Quali A ent: - Address: 41a0 B'-aCity 144b1 IfILI State ,L, Office Phone 910- L Ll 90 Job Site/Contact Number /-D 443 Fax# °7X/- Q 11-9b ge State Certification/Registration# C C, x 0 9 8 0 Architect Name&Phone# ' i 1 n i na ,o S Engineer's Name&Phone# — actin oe,r. TOh, rac c a — Fee Simple Title Holder Name and Address Bonding Company Name and Address Mortgage Lender Name and Address Applns ication is hereby made to obtain a permit to do the work and installations as indicis sated. l certify that no work or installation has commenced prior to the issuance of a permit and thcomat all work will thin sbe performeer d to meet the stantrctdards of all laws rpegulating construction in thor is jurisdiction. This permit becomes null and work is�o menced.ot I understain C'nden dxthat separate pe6 in t itsom st be secured for Elon ectrical Workd Plumbing, Signedns,aWells�P olsX uinaees,Boilermonths at ys t eatime ers, Tanks 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 FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. I here b certify that 1 have read and examined this a plication and know the same to be true and correct. All provisions of laws and ordinances governing this type o work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisi.ons of any other federal,state, or l cal l r gulating construction or the performance of construction. Signature of Owner Signature of Contractor S S L J n L r'lf ` Print Name �j? Print Name .nr!...... :.......,5 �.• r.:.�................................................ Sworn o and subscribe before e Sworn t9 and subscribed Jae ore me 20/� this/ bay of �� 20�3 this/f Day of ej:f t MY ILLS ALVAREZ 10 otary Pub7c ;�;., EXPIRES October 01,� 15 N °c 1MY OOMMISSION#EE13191v • OF F`,�� (407)398-0153 FloridallotaryServfce.com =�;�,.o Et4PtRESOctober�J1,��is d 01.26.10 (407J ':053 »Ilftidallotaryservicecom PRODUCT APPROVAL INFORMATION SHEET FOR DUVAL COUNTY, FLORIDA Project Name: ermit Project Address: Lie 1 )L As required by Florida Statute 553.842 and Florida Administrative Code 913-72 , please provide the information and product approval number(s) for the building components listed below as applicable to the building construction project for the permit number listed above. You should contact your product supplier if you do not know the product approval number for any of the applicable listed products. Information regarding statewide product approval may be obtained at: www.floridabuilding.org. Cate o /Subcate o A. EXTERIOR DOORS Manufacturer Product Descriptior Limits of Use State # Local # Masonite Wood Edge Steel See Manufacturer's Specifications 1 N/A Door 1. Swinging i\1 Masonite Fiberglass Door See Manufacturer's Specifications 1 /A Units OXO 180 X 96 C-30 DP+30/-30, OXO 108 X 96 C-50 DP+50/-50, All Windows are to be Installed per Capitol Aluminum Sliding Manufacturer's Installation Drawings. FL1865 N/A Glass Door Anchor Size, Type and Spacing are determined by the type of construction per Manufacturer's Installation Drawings. 2. Sliding General Aluminum Sliding Aluminum Glass Door SGD-C35 FI-264.1 N/A Company Overhead Door Series 180/280/380 25/37.5 psf, 16' max - dwg #409335 IFI-674.2 N/A 3. Sectional Corporation Overhead Door Series 180/280/380 26/39 psf, 16' max - dwg #409885 FL674.8 N/A Corporation k-/library/forms/PRODUCTAPPREV.XLS 2013-10-17 08:00 Building Dept. 247 5845 >> 4042252736 P 1/1 !d i�.AJ`1j• IJL 1F1�L1]L�iTII BL` LH Building Department �' sJ 300 S=inole Road • r Atlantic Boach,Florida 32233 (904)247-5800 PLAN REVIEW COMMENTS Permit Application # l '3— SS 3o Property Address: 4XO J' dreg RO,. Applicant: seo/a �on_S�ruc 7rtl_/t Project: GC,r,Prg ��t.,#7ova2�4 3 This permit application has been: ❑ Approved ❑ Reviewed and the followiag items need attention: d`O0111le reyva 70v Sacl-erA7& f. ri 7�,� Woo/C Xk Please re-submit your application when these items have been completed. Reviewed By: /71 Date: 10—Y/7—/9 10/17/2013 16: 3, 9042252736 SEDA HOMES PAGE 02/0 10117/13 Norlda Building Go&Online �w• y��tyi., . P4403aw Mill Sii Fk idg[??p1111 Waf 13CIS Home Lop In I V qr Registration Hot Topic. Submit Surcharge Stats&Ira cm PubhOatlons F13C Staff SCIS Site Map Llnlca I Searth 3usii esVj$ Product Approva I fro essi � I USER:Public user Regulation MMkr PrpsluctAonrovel Menu>p�gr. �E arAa^11�Iqp^�y ry,b, Apppoatlon List IGYfO Search Criteria .&fh§ Scarth Code Versfon 7010 FL# 12769.1 Application Type ALL Product Manufacturer ALL Category ALL Subcategory ALL Application Status ALL Compliance Method ALL Quality Assurance Fruity ALL Quality Assurance Entity Contract Expired ALL Product Model, Number or Name ALL Product Description ALL Approved for use In HVHZ AI-L Approved for use outside HVHZ ALL Impact Resistant ALL Design Pressure ALL Other ALL Search Results-Apilcntions --- ...... ......- ._......__..._,.,..,.,.,,........- .._..._,_,...,.._..W..._. �...._ ._............_................Val...... g_...,.-........................,,.....,.-. _......................,,.., � �.,Zypg, Manufacturer v �� 127G9 Revlsfon JELD-WEN National Accreditation& Approved FLFi#: FL12769.1 Management Institute, History Mads[, Contour 13mri lum Steel VJood Edge Glazed Door (SO t) 684-5124 Description: 12'-0"x 8'-8",Glazed, Steel, Wood Edge, Inswing Door System with and without Sldelltes , Category: Exterior Doors Subcategory:Swinging Exterior Door Assemblies *Approved by DOR.Approvar�y oed :nail ne revleWed and mtined by the POC and/of the CommUaen IP nrceseary. Cortnct us;:1,&rth Monroe street.Tallahassee FL 32399 Phon:� 850.487.1824 The State of Fiorids L an AA/EtO employer,CogyrIght;(7,d>-Ztl13 SGntn o Florida,:;Eay21_Stntement::arr..csibtlity_Stntament;:Rerund Statement under Plodde iaw,email addrette5 are public records.Ir you do not want your a-moll address mieasod In fel0thte to a pubrlrrtcords request,do not send electronic all to this entity,instnnd,wntact the office by phone or by traditlonel mail,If you hnve any questions,please wntack 850.467,1395,"Puruent to Section 455,275(1),Florida Statutes,effective odobnr%,2012,licensees Ilcchstd under Chapter 45S,F.5,must Provide the Department With an email addross if they have.onn.Thn smalls provicind may be used for Official communipition W1th thn hcon%cw Hcvpver email addrossts am public record.If you do not NO to supply n personal address,please provide the Departmen`in tli an eptert add s.plase clickhsemade avallablo to tl+n public.To drtormind if you Pre a licensee Product Approval Accoptsi 91 5 S.vJlhi k Now vct:urftyx xtwte;. Kim E �IFf /+ 1 Ji http9:Auwuw,flarid2lauilding.org/pr/pr app Ist,za9px S rL`Jr �s lea , CITY OF ATLANTIC BEACH J 800 SEMINOLE ROAD J r ATLANTIC BEACH,FL 32233 ELECTRICAL PERMIT INSPECTION PHONE LINE 247-5814 CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 JOB INFORMATION: lob ID: 14-ELEC-97 lob Type: ELECTRIC ONLY Description: MISC BATHROOM REMODEL Estimated Value: Issue Date: 10/7/2014 Expiration Date: 4/5/2015 PROPERTY ADDRESS: Address: 408 IREX RD RE Number: 171419-0000 PROPERTY OWNER: Name: ISLEY JR, RALPH Address: 408 IREX RD FEES: State Elec DBPR Surcharge $2.00 State Elec DCA Surcharge $2.00 Electrical Repairs $35.00 Trade Permit Base Fee $55.00 Total Payments: $0.00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. CITY OF ATLANTIC BEACH l 800 SEMINOLE ROAD 1 r� ATLANTIC BEACH,FL 32233 ELECTRICAL PERMIT INSPECTION PHONE LINE 247-5814 i CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 JOB INFORMATION: Job ID: 14-ELEC-97 Job Type: ELECTRIC ONLY Description: MISC BATHROOM REMODEL Estimated Value: Issue Date: 10/7/2014 Expiration Date: 4/5/2015 PROPERTY ADDRESS: Address: 408 IREX RD RE Number: 171419-0000 PROPERTY OWNER: Name: ISLEY JR, RALPH Address: 408 IREX RD FEES: State Elec DBPR Surcharge $2.00 State Elec DCA Surcharge $2.00 Electrical Repairs $35.00 Trade Permit Base Fee $55.00 Total Payments: $0.00 it PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. ?� '.V CITY OF ATLANTIC BEACH s 800 SEMINOLE ROAD J ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Wilt Application Number . . . . . 13-00003530 Date 9/09/14 Property Address . . . . . . 408 IREX RD Application type description RESIDENTIAL ALTERATION Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 60000 ---------------------------------------------------------------------------- Application desc GENERAL ADA RENOVATIONS ---------------------------------------------------------------------------- Owner Contractor - ------------------------ ----------------------- ISLEY, JR. , RALPH SEDA CONSTRUCTION COMPANY 408 IREX ROAD 2120 CORPORATE SQ. BLVD. #3 ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32216 (904) 591-2723 --- Structure Information 000 000 GENERAL ADA RENOVATIONS Occupancy Type . . . . . . RESIDENTIAL ---------------------------------------------------------------------------- Permit PLUMBING PERMIT Additional desc . . Sub Contractor . . CALL PLUMBING INC Permit Fee . . . 76 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 3/08/15 ------------------------------------------------------------------ Special Notes and Comments 2010 FLORIDA BUILDING CODE, 2008 NATIONAL ELECTRIC CODE *REPORT ANY UNFORSEEN STRUCTURAL DAMAGE TO THE BUILDING DEPARTMENT IMMEDIATELY. WINDOW AND DOOR INSPECTION: *INSTALLATION INSTUCTIONS REQUIRED *ALL STICKERS ARE TO REMAIN ON THE WINDOWS *PROVIDE ACCESS TO ALL WINDOWS TO INSPECT FASTENERS ------------------------------------------------------------ Other Fees . . . . . . . . . STATE PLBG DCA SURCHARGE 2 . 00 STATE PLBG DBPR SURCHARGE 2 . 00 ------------------------------------------------------------ Fee summary Charged Paid Credited Due ----------------- ---------- ---------- ---------- ---------- Permit Fee Total 76 . 00 76 . 00 . 00 . 00 Plan Check Total . 00 . 00 . 00 . 00 Other Fee Total 4 . 00 4 . 00 . 00 . 00 Grand Total 80 . 00 80 . 00 . 00 . 00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. id PLUMBING PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd Atlantic Beach, FL 32233f Ph(904) 247-5826 Fax (904) 247-5845 12 JOB ADDRESS: Z PERMIT # NEW OR REPLACEMENT INSTALLATION: Project Values TYPE of FIXTURE QTY TYPE of FIXTURE QTY Bathtub Septic Tank&Pit Clothes Washer Shower Z 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 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 au ority to violate the provisions of any other state or local law regulation construction or the performance of construction. Property Owners Name h �� Phone Number Plumbing Company G G �lv w�•-�/ Office Phone Fax Co. Address: 5� {� �-e/-/7 City �4ci�fog ,U//�t State Zip Z d License Holder(Print): ewr State Certification/Registration#CjOc_�f-OS192� Notarized Signature of License Holder Before me this day of 20 Signature of Notary Public CITY OF ATLANTIC BEACH ss1 J 800 SEMINOLE ROAD r ATLANTIC BEACH,FL 32233 ELECTRICAL PERMIT INSPECTION PHONE LINE 247-5814 CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 JOB INFORMATION: Job ID: 14-ELEC-97 Job Type: ELECTRIC ONLY Description: MISC BATHROOM REMODEL Estimated Value: Issue Date: Expiration Date: PROPERTY ADDRESS: Address: 408 IREX RD RE Number: 171419-0000 PROPERTY OWNER: Name: ISLEY JR, RALPH Address: 408 IREX RD FEES: State Elec DBPR Surcharge $2.00 State Elec DCA Surcharge $2.00 Electrical Repairs $35.00 Trade Permit Base Fee $55.00 Total Payments: $94.00 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: 0 1� - 9-0 - PERMIT 1$1-0 0 003Q0 JEA INFORMATION REQUIRED ON ALL PERMITS AMPS VOLTS PHASE VALUE OF WORK$ NEW SERVICE ❑ Overhead ❑ Underground ❑T Underground up Pole _:Residential(Main) Service -0-100 amps 101-150amps 11151-200amps amps #of Meters Commercial(Main) Service 0-100 amps 101-150amps '151-200amps amps CT Service amps Conductor Type Size Multi-Family(Main)Service 0-100 amps 101-150amps 151-200amps amps #of Unit Meters Temporary Pole ' amps SERVICE UPGRADE i amps , CT Service amps NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.) -100 amps -1150amps F !200amps E amps -CT Service amps ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC. Outlets/Switches: 0-3 Damps 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 1SwimmingPool - Sign ❑Smoke Detectors_Qty AT ransformers KVA -Motors hp FIRE ALARM SYSTEM (Requires 3 sets of plans) Qty volts/amps VALUE OF WORK$ REPAIRS/MISCELLANEOUS r Replace Burnt/Damaged Meter Can L I Safety Inspection 1,Panel Change 'OH to UG -]Other: fi&Aoc 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 Q rA I P h T�- t/ a Ty-- Phone Number Electrical Company -D+ W E L 6 C Tib L C C 0- �_�C - Office Phone '7 8 6 "3 V-7 O Fax 7 8(o "/F 8 Co. Address: P o• B o X 3 7l(c y City ,Ta ck9 an Ildle, State FL zip 3-�a 3 b License Holder(Print): N G L L• (Z rL/e State Certification/Registration#Ee veva Notarized Signature of License Holder rn and subscribed before me this (o day of 6 49,X, 20 /4 M~- JANICE E.CARTER Commission#FF 036459 Si ature of Notary Public �= Expires September 25,2017 Oonded Thm Troy Fan Insurance 800.385.7019