90 FORRESTAL CIR - ELECTRICAL Cash Register Receipt Receipt Number
City of Atlantic Beach R7991
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DESCRIPTION I ACCOUNT I QTY PAID
PermitTRAK $94.00
15-ELEC-2375 Address: 90 S FORRESTAL CIR APN: 171751 0000 $94.00
BUILDING $94.00
BUILDING PERMIT RENEWAL 455-0000-322-1000 0 $94.00
TOTAL FEES PAID BY RECEIPT: R7991 $94.00
Date Paid: Wednesday, January 30, 2019
Paid By: ATLANTIC RESTORATION COUNCIL INC
Cashier: LE
Pay Method: CHECK 15894
Printed:Wednesday,January 30,2019 10:41 AM 1 of 1
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City Lien Search Results
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Utilities: As of 12/14/2018, no unpaid utility balances were found on this property.
Permitting: As of 12/14/2018, an Issued permit was found on this property. Per the building
department, there were no inspections called in. A fee of $94 needs to be paid to reissue the
permit, and a final inspection will need to be passed in order to close it.
Issued Permit#: 15-ELEC-2375
Code Enforcement: As of 12/14/2018, no open code violations or other code enforcement issues
were found with this property.
Contact Information:
City of Atlantic Beach
Attn: Cashiers Office
ATTN: Parcel No: (insert parcel numb
800 Seminole Road
Atlantic Beach, FL 32233
Phone: (904) 247-5809
90 S . Fo r re.S-o`` C Ir
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' '` �1, CITY OF ATLANTIC BEACH
.k. " "-� 2 800 SEMINOLE ROAD
- ;r ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
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ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-ELEC-2375
Job Type: ELECTRIC ONLY
Description: ELECTRICAL - REPAIR
Estimated Value:
Issue Date: 10/7/2015
Expiration Date: 4/4/2016
PROPERTY ADDRESS:
Address: 90 FORRESTAL CIR
RE Number: 171751-0000
PROPERTY OWNER:
Name: MABRY TRUST ET AL, PETER
Address: 407 S OCEANWALK DR 407 S OCEANWALK DR
GENERAL CONTRACTOR INFORMATION:
Name: BEACH ELECTRICAL INC
Address: 1272 NIPIGON AVE QA WILLIAM G. POEHLMAN
Phone: - -
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: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach, FL 32233
Ph(904)247-5826 Fax (904) 247-5845 15 EL-ea- 23-75
JOB ADDRESS: .0 v.6Ze�STAI L c.../geg S PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS /ov AMPS `,1- VOLTS / PHASE
VALUE OF WORKS �01.7
NEW SERVICE ❑ Overhead ❑ Underground I 11 Underground up Pole
❑Residential(Main)Service
0 0-100 amps ❑101-150amps 0151-200amps ❑ amps # of Meters
❑Commercial(Main)Service
00-100 amps D101-150amps 0151-200amps h amps 7 C Service amps
Conductor Type Size
❑Multi-Family(Main)Service
00-100 amps ❑101-150amps 1 151-200amps ❑ amps # of Unit Meters
❑Temporary Pole 0 amps
SERVICE UPGRADE 0 amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
0100 amps ❑150amps l200amps ❑ amps OCT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-30amps 31-100amps 101-200amps
Appliances: 0-30amps 31-100amps 101-200amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
❑Swimming Pool 0 Sign ❑Smoke Detectors_Qty ❑Transformers KVA ❑Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REP/AS/MISCELLANEOUS
eplace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change DOH to UG
❑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. �p /�
Property Owners Name A f G vS a-S Phone Number '3 72 —/ /C9
Electrical Company )715/1 at 61,6"c-4-12-t C,t L /N G Office Phone o ' 1 Fax
Co.Address: 1272 /iii "GaN '1Vo A City A - 6 - State n Zip
License Holder(Print): wltclho a'raOSff L1f/bil State Certification/Registration#eg 13o 7/7 �/
Notarized Signature of License Holder ' /' !'
;rQ:,,,,,, .;' 'DAYNA H.WILLIAMS Before me this 10 day •f Co&ER 20 i s
,: ,�� ;., MY COMMISSION Y FF 217841
EXPIRES:August 7'2019 Signature of Notary Public iiir C WJL0- x-
'"f„fly„!` Bonded Thru Notary Pubic Undervaden g Y
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