Permit Sign & Elec 695 Atl 2011 rl
6 4 0.„,p,
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5826
Application Number 11- 00001532
Property Address Date 2/22/11
ATLANTIC
Application type description SIGNPERMIT BLVD
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
sign w/ elec
Owner Contractor
ELITE PRO REALTY BUDNIK AND D ELECTRICIAL CONTR
6703 LAURINA PL
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32216
Permit ELECTRICAL PERMIT
Additional desc .
Permit Fee . . . 90.00 Plan Check Fee .00
Issue Date Valuation . 0
Expiration Date . . 8/21/11
Special Notes and Comments
*2007 FLORIDA BUILDING CODE W/2009 REVISIONS
FLORIDA FIRE PREVENTION CODE
NATIONAL ELECTRIC CODE
Fee summary Charged Paid Credited Due
Permit Fee Total 90.00 90.00 .00 .00
Plan Check Total .00 .00 .00 .00
Grand Total 90.00 90.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
$DING PERMIT APPLICATION
w CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247 -5826 Fax (904) 247 -5845
Job Address: , # J , 41"40 i a" 9L VA
Permit Number: /-- / 3 .,
Legal Description
Floor Area of Sq.r't• Parcel #
Valuation of Work $ ci/7 Proposed Work heated /cooled / n on -
non 3liga
non
Class of Work (circle one): New Addition Alteration Repair Move Demolitio U `
window /d„
Use of existing /proposed structure(s) (circle one): mer r_ JAN 05 2 A 1
If an existing structure, is a fire sprinkler system inst ed. A (Circle Res
e one): id sntia o \tj .
Florida Product Approval #
For multiple products use product approval orf - /' - �
BY
Describe in detail the type of work to be performed: y/Z5 j/9// /2mi1 51 ' , l Cp l/ re 0 cane
apse L/vQ .• L -W ix + "
Property Owner Information:
Name: % / or > i/ Addr s: i o P 0, B x 5 O 6
City 0 ,12, li State i p one 0 / ♦ s
E -Mail or Fax # (Optional)
/
Contractor Information: V 3 , ?,9 1 70
Company Name: 3i2 d/V ik and 0 i.:71 f e' 2 , Qualifying Agent: / , 814 ( � i 9/ /
Address: /i 70 _ 1124tR..//Va.- city
Office Phone �' Ci 5 ,
Uii/State �( Zip ,�aC�jr
Job Site/ Contact Number Fax #
State Certification/Registration # ,1._ /11 l (/
Architect Name & Phone #
Engineer's Name & Phone #
Fee Simple Title Holder Name and Address // fr /PO ,9Pa /i'
Bonding Company Name and Address
Mortgage Lender Name and Address
4pplication is hereby made to obtain a permit to do the work and installations as indicated I certify that no work or installation has commenced prior to the
'ssuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null
212d void zfwork is not commenced within six (6) months, or if construction or work is suspended or abandoned for a_period ofsix 6) months at any time after
work is commenced I understand that separate permits must be secured for Electricar Plumbing, Signs, ells, Pools, Fu rnaces, Bo Heaters,
Tanks and Air Conditioners, etc.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMIVIENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR EVIPROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMIVIENCEMENT.
rhereb certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this
ype of work will be complied with whether specifd herein or not. The granting of a permit does not presume to give authority to violate or cancel the
irovisions of any other federal, state, or local law regulating construction or the performance of construction.
C /
signature of Owner ii /' �/
/
1 - Si gnature of Contractor / � A l a ,
'Tint Name v N.► by\ 1,...k,-e_.1 \ N , 4N Print Name
)y. ' r Inzi f "♦ i . . .. _ Sworn oian, - , r - • /y�
in I ' 1 i a � i � r . ,n nz..r.— ! ' this ( % • : �� 20 �l/ . 74147, 1 17
Ilk O I • 1 ■ y + v � i4: lt t ?.ri 1,� 60 I + avle�rr ar w�ucpw , � � � � . 1
-1.441t211`.'-'4 ■ y , . .
REQUI ' 1 i 'i� r il ti -'! + =t ' ► r r 1
ar
1 Revised 01.26.10
REVIEWED BY: `1 DATE: I / —// FILE C
.,
F)
* ELECTRICAL PERNIIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
Ph (904) 247 -5826 Fax (904) 247 -5845 - "
JOB ADDRESS: 69S" /9 7`L ,1I ,6 PERMIT # l/ — /5
NEW SERVICE DOverhead ❑ Underground ❑ Underground up Pole
❑Residential (Main) Service
00 -100 amps ❑ 101- 150amps ❑ 151- 200amps ❑ amps # of Meters
❑ Commercial (Main) Service .
00 -100 amps 0101- 150amps ❑ 151- 200amps ❑ amps OCT Service amps
Conductor Type Size
❑Multi- Family (Main) Service
❑ 0 -100 amps ❑ 101- 150amps ❑ 151- 200amps 0 amps # of Unit Meters
❑Temporary Pole 0 amps
SERVICE UPGRADE 0 amps ❑ CT Service amps
NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.)
❑ 100 amps ❑ 150amps 0 200amps ❑ 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 Sign OSmoke 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
DReplace Burnt/Damaged Meter Can ❑ Safety Inspection ❑Panel Change ❑ OH to UG
❑ Other: 2 N Oil ( V
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 E /1i Pkto ifeiloai Phone Number
Electrical Company 7 . CM/ K- L2Gtd J I 6 Office , Of ce Phone 90 VI
Co. Address: 6 l DJ? Z46612_ // 6 ,' City ? State /( Zip ,3,f.9-/
License Holder (Print): 414 X //z? 44.44 State Certification/Registration # 52 /S
Notarized Signature of License Holder # , ice / /
Sworn'and subscribed before me di "Ati,' � •
, X �!P DD S "775;
Signature of Notary Public ! xi , "` * : '' .aty ;4,2'3
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f s`�r f � 3 City of Atlantic Beach
r.s Building Department APPLICATION NUMBER
(To be assigned by the Building Department.)
' 800 Seminole Road
Atlantic Beach, Florida 32233 -5445 ///. r- 53
' Phone (904) 247 -5826 • Fax (904) 247 -5845
.ar k E -mail: building- dept @coab.us Date routed: / 1/
City web -site: http: / /www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: C' 95 1-774 „ - v d Department review required quired Ye No
B.uildir3c _ ...__._..
Applicant: / 749.1)- ) i C /' 54-7 £ / /1 tannin & Z
_g on4:
/ � �
1 ree Administrator
Project: S"7 C� �/ Public Works
// Public Utilities
Public Safety
Fire Services
Other Agency Review or Permit Required Review or Receipt
of Permit Verified By Date
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.
(Circle one.) Comments:
BUILDIN
PLANNING & ZONING
Reviewed by: / Date: ,g ."#—//
TREE ADMIN.
Second Review: Approved as revised. ❑De ied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: ❑Approved as revised. DDenied.
Comments:
Reviewed by: Date:
Revised 05/14/09
LA4:r,, ,,, City of Atlantic Beach
' k".4 f, Building Department APPLICATION NUMBER
'' a 800 Seminole Road (To be assigned by the Building Department.)
Atlantic Beach, Florida 32233 -5445
Phone (904) 247 -5826 • Fax (904) 247 -5845
i Mr
.4 �(rt sp E -mail: building- dept @coab.us
City web -site: http: / /www.coab.us Date routed:
APPLICATION REVIEW AND TRACKING FORM
Property Address: i a n - A G
Z /v el De s artment review required 11S231 No
Applicant: ■ i C /� - b ■ // t B ildi ,
/G�� 'tanning & ZoniAIIIIIIIIII
Project: S--) j ree ' • mmistrator _ -
Public Works -
Public Utilities _-
Public Safety _-
" .tpep i S ign tur -
Other Agency Review or Permit Required Review or Receipt
of Permit Verified B Date
Florida Dept. of Environmental Protection mons..... 1111111111111.1 m 111.. 11,=.1111111111111111
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. 4Denied.
(Circle one.) Comments:
BUILDING StehS 0 -a/e, eCOhj C 17- 42 0)]
'� ANNING & ZONING (131/1 3 be at s loewl a td&�
Reviewed by: vie-4- C._ L°1.1
TREE ADMIN. Date:
Second Review: x Approved as revised. ❑Denied.
PUBLIC WORKS Comm
PUBLIC UTILITIES • IS
PUBLIC SAFETY Reviewed by: 4.„•:411 ' i Date:
Z 13�1o//
FIRE SERVICES Third Review: []Approved as revised. ['Denied.
Comments:
Reviewed by: Date:
t t,,\AS