1296 Beach Ave - Electric for Remodel CITY OF ATLANTIC BEACH
1 s> 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
-5511 INSPECTION PHONE LINE 247-5814
ELECTRICAL RESIDENTIAL -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: ERES17-0163
Description: 400 amps 240 volts 1 phase
Estimated Value: 9000
Issue Date: 10/23/2017
Expiration Date: 4/21/2018
PROPERTY ADDRESS:
Address: 1296 BEACH AVE
RE Number: 171833 0020
PROPERTY OWNER:
Name: CHANDLER PHILLIP
Address: 1296 BEACH AVE
ATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: HAZOURI ELECTRIC, INC.
Address: P O BOX 56559 P.O. BOX 56559
JACKSONVILLE, FL 32241
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$7,500.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach, FL 32233
Ph(904)247-5826 Fax (904)247-58455(7 d (Q 3
JOB ADDRESS: 1 p� v PERMIT# _
JEA INFORMATION REQUIRED ON ALL PERMITS _VUP AMPS Z Y VOLTS
/ PHASE
VALUE OF WORK$ Qm g
NEW SERVICE ❑ Overhead ❑ Underground
❑Residential(Main)Service g Underground up Pole
00-100 amps ❑101-150am s
P ❑151-200amps ❑ amps #of Meters
❑Commercial(Main)Service
00-100 amps ❑101-150amps ❑151-200amps ❑
Conductor Type Size —am s
p OCT Service amps
❑Multi-Family(Main)Service
00-100 amps ❑101-150amps ❑151-200amp s ❑
❑Temporary Pole ❑ amps amps #of Unit Meters
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps ❑150amps 0200amps ❑ amps OCT Service amps
P
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: / 0-30amps 31-100amps 101-200am s
Appliances: —_0-30amps 31-100am s p
A/C Circuits: 0-60am s 61-100amp 101-200amps
P ps
Heat Circuits: # circuits
Number of Lighting Outlets, Including Fixtures: 1/0-
OTHER ELECTRICAL PROJECTS
❑Swimming Pool ❑ Sign ❑Smoke Detectors_Qty ❑Transformers KVA ❑Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VAL UE OF WORK$
REPAIRS/MISCELLANEOUS
❑Replace Burnt/Damaged Met r Can ❑Safety Inspection ❑Panel Change DOH to UG
❑Other: On
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 /t�C�.�2 Phone
Number
i
Electrical Company — Office Phone (.1 c f l 3
y#ax
Co.Address: �i .tt�( Ci I
tY �n/Reakt,
State � Zip 3�
License Holder(Print): State ation# �l3 7�
Notarized Si r older
CHO ROBERTS
MY COMMISSION#FF153136 Before me this�_day of 20
y9,OF � EXPIRES:August 21,2018
Signature of Notary Public �
'rt L:L`1Y
l Cash
� v of
Atlantic Beach •
DESCRIPTION ACCOUNTQTY PAID
PermitTRAK $80.00
ERES17-0163 Address: 1296 BEACH AVE APN: 171833 0020 $80.00
ELECTRICAL $76.00
ELECTRICAL BASE FEE 455-0000-322-1000 0 $55.00
ELEC LIGHTING OUTLETS,INCLUDING 455-0000-322-1000 10 $6.00
FIXTURES
ELEC SWITCH AND RECEPTACLE OUTLETS 455-0000-322-1000 0 $9.00
ELEC APPLIANCES FIXED OR STATIONERY 455-0000-322-1000 0 $6.00
STATE SURCHARGES $4.00
STATE DBPR SURCHARGE 455-0000-208-0600 0 $2.00
STATE DCA SURCHARGE 45500002080700 0 $2.00
TOTAL „ $80.00
CO W
co .� o
N O O ♦O O
Q_
xX
N
m pOC ^ C
V J ce
HQ
Z Z Q V
�
co r- 4 m
a N S o
O O Z V V
r °D
V Q rr
O
CV -�F U _� 3X y � � � 1• f
M O O L 2 .71
y J
Date Paid: Monday, October 23, 2017
Paid By: HAZOURI ELECTRIC, INC.
Cashier: ME
Pay Method: CREDIT CARD 3
/[ti
Printed: Monday,October 23,2017 2:15 PM 1 of 1 1,