2235 W Oceanforest Dr electrical permit CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
ELECTRICAL RESIDENTIAL -
MUST CALL BY 4PM FOR NE)ff DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: ERES17-0132
Description: 200 ampsJ240 volts/single phase-4 outlets, 10 fixtures
Estimated Value: 3000
Issue Date: 9/21/2017
Expiration Date: 3/20/2018
PROPERTY ADDRESS:
Address: 2235 W OCEANFOREST OR
RE Number: 1694630670
PROPERTY OWNER:
Name: PETERSON WILLIAM D
Address: 2235 OCEANIFOREST DR W
ATLANTIC BEACH, FIL 32233-4569
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: LORE ELECTRICAL CONTRACTORS
Address: 210 N ROSCOE BLVD 210 N. ROSCOE BLVD
PONTE VEDRA BEACH, FIL 32082
Phone:
PERMIT INFORMATION:
Please see attached conditions of approval.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOU 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.
* A notice of Commencement is only required for work exceeding an estimated value of
$2,500.For HVAC work, a Notice of Commencement is only required when HVAC work
exceeds and estimated value of$7,500.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach,FL 32233
Ph(904)247-5826 17�(904)247-5845 cf-ts (I - 6(N-
JOB ADDRESS: 2 2 3S 0 . Q,,-
0/) .
JEA INFORMATION REQUIRED ON ALLPERMITS 3,t�"� ANTS 2,/OVOLTS PHASE
VALUEOFWORKS- 3a�b
NEW SERVICE 1:1 Overhead Underground D Underground up Pole
EIResidential(Main)Service
00-100amps 0 101-ISOMPS El 15 1-200amps 0 amps #of Meters
ElCornmercial(Main)Service
0 0-100 amps E1101-150amps D 151-200amps 0 amps OCT Service amps
Conductor Type Sim
OMuld-Family(Main)Service
E10-100 amps 0101-150amps El 151-200amps El .....amps #of Unit Meters
[]Temporary Pole L.]____amps
SERVICE UPGRADE 0 amps El CT Service_amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
D100anips U150amps F1200amps 0 amps OCTServiceamps
ADDITIONS,REMODELS REPAIRS BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-304;�P' 3 1-1 00amps —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 Fbx—ture�. /0
OTHER ELECTRICAL PROJECTS
,SwimmingPool Sign El Smoke Detectors_Qty OTransformers KVA DMotorshp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty—volts/amps— VALUEOFWORKS
REPAIRSMSCELLANEOUS
0 Replace Burnt/Darmaged Meter Can OSafety Inspection OPimelCharge 11OH to UG
00ther:
Permit becomes void if work does not cammence within.six month period or work is suspended or abandoned for six=nibs. I hereby certify that I have
read this application and know the same to be mic and correct. All previsions of laws and ordinances governing this work will be complied with whether
specified or not. The permit does not give ambority to violate the provisions of my other state or local law regulation construction or the performance of
construc(ion.
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Prop"'rly Own Name
Electrical Company rWe' Office Phone Fax
Co.Address: 2-f 0 &L city State Zip ;Zdr
License Holder(Print): L
�State Certification/Registration#if&1Jo1f&L4
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NotarimdSi a 'older
�NJFERJDHNSTON
WroMMISSIONOGG0429" Before me this day of G4)�V 64-r 20 tq-
UPIRES��121.= Public
Signature of Notary
RV
Cash Register Receipt Receipt Number
is City of Atlantic Beach R2734
DESCRIPTION ACCOUNT CITY PAID
PermitTRAK $67.40
ERES17-0132 Address: 2235 W OCEANFOREST DR APN: 169463 0570 $67.40
ELECTRICAL $63,40
ELECrRICAL BASE FEE 455-0000-322-1000 0 $55 00
EUEC SWITCH AND RECEPTACLE OUTLETS 455-0000-322-1000 0 $2.40
ELEC LIGHTING OUTLETS,INCLUDING 455-0000-322-IOM 10 $6.00
FIXTURES
STATE SURCHARGES .00
STATE DBPR SURCHARGE 455�"D-208-0600 $2.00
2
STATE DCA SURCHARGE 4550DO02OW700 0 $2.00
TOTAL FEES PAID BY RECEIPT: R2734 $67.40
Date Paid:Thursday,September 21, 2017
Paid By: LORE ELECTRICAL CONTRACTORS
Cashier: GA
Pay Method:CREDIT CARD 8
Printed:Thursday,September 21,2017 12:32 PNI 1 Of I
V1.19
Receipt Number
Cash Register Receipt
Lx) City of Atlantic Beach R2955
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $55-00
ERES17-0132 Address:223S W OCEANFOREST DR APN: 169"3 OS70 $SS.00
ELECTRICAL ROUGH 09/22/2017 RBE $55.00
ELECTRICAL ROUGH 09/22/2017 RBE 1 45500003221002 0 1 $55.00
TOTAL FEES PAID BY RECEIPT: R2955 $55.00
CITY OF ATLANTIC BEACH
800 SEMINOLE RD
ATLANTIC BEAC,Fl.32233
09�29,i2017 11:38:28
CREDIT CARD
MC SALE
Card XXVZX=4133
SEQ#: 5
Bath#: 452
INVOICE 5
Approval Code: 46767P
Enty Mediod: Mml
Mode: Onlix
Card Code: M
SkE AMOUNT $55m
CUSTOMER COPY
Date Paid: Friday, September 29, 2017
Paid By: LORE ELECTRICAL CONTRACTORS
Cashier: BA
Pay Method: CREDIT CARD 5
Printed: Friday,September 29,2017 11:46 AM 1 of 1