390 SKATE RD - ELECTRIC UPGRADE 4' CITY OF ATLANTIC BEACH
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? 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
ELECTRICAL R SIDENTIAL -
MUST CALL BY 4PM FOR NEXT AY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: ERES17-0173
Description: 150 amps/240 volts/ ingle-phase-service upgrade
Estimated Value: 0
Issue Date: 10/30/2017
Expiration Date: 4/28/2018
PROPERTY ADDRESS:
Address: 390 SKATE RD
RE Number: 171667 0000
PROPERTY OWNER:
Name: Dolfin Properties LLC
Address: 1817 Twelve Oaks Lane WestGreg Scott Williams
Neptune Beach, FL 2266
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name:
Address:
Phone:
PERMIT INFORMATION:
Please see attached conditions of approval.
WARNING TO OWNER: YOUR FAILRE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT I YOU PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPS ' TY. A NOTICE OF
COMMENCEMENT MUST BE RECO 1 ED AND POSTED ON THE JOB
SITE BEFORE THE FIRST INSPECT ION. IF YOU INTEND TO OBTAIN
FINANCING, CONSULT WITH YO ' LENDER OR AN ATTORNEY
BEFORE RECORDING YOUR NOTI 1 E OF COMMENCEMENT.
* A notice of Commencement is only required or work exceeding an estimated value of
$2,500. For HVAC work, a Notice of Commen ement is only required when HVAC work
exceeds and estimated value of$7,500.
1
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
.s 800 Seminole Rd,Atlantic Beach,FL 32233
Ph(904)247-5826 Fax (904)247-5845 E e-&SIS—0
f 9-3
JOB ADDRESS: 3d0 J ,t G" ed PERMTT# 8c /? (Dao t
JEA INFORMATION REQUIRED ON ALL PERMITS I50 AMPS 2.10 VOLTS / PHASE
VALUE OF WORK S
NEW SERVICE ErOverhend ❑ Underground ❑1 Underground up Pole
°Residential(Main)Service
00-100 amps ;1401-150amps Ul51-200amps , .. amps of Meters
.Commercial(Main)Service
i.?0-100 amps 101-150amps 00151-200amps amps '.,CT Service amps
Conductor Type Size
.Multi-Family(Main)Service
DO-100 amps 0101-150amps. !..:151-200atnps ' amps #of Unit Meters
CITemporary Pole 0 amps
SERVICE UPGRADE . /50 amps ... CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,E .)
0100 amps r 150amps 200amps amps :CT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESS RY STRUCTURES,ETC.
Outlets/Switches: 0-30amps 31-1O0amps 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 '1 Sign '._:Smoke Detectors Qty _Transformers KVA .'.,Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK S
REPAIRS/MISCELLANEOUS
°Replace Burnt/Damaged Meter Can -iSafety Inspection ' Panel Change OH to UG
0Other:
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()flaws 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 -r+ t I�71'ft aN 5 Phone Number S-36- 1 b
/ti
Electrical Company fft(lnr ( (tt.=CTM C-- LC,C- ' Office Phone .2417-98 Fax
Co.Address: 6 1 1 i t-` /] City 14-'x. &�t. State I L Zip 727“,
License Holder(Print): 'Ire all In tate Certification/Registration# E l 301252,;
Notarized Signature of License Holder .
Aft
111 1 Sworn and subscribed before tare this ar , .ay o __ 1_
Signature of Notary Public
-
Twee/Wel"Paulsen
4PUBL
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:-oorrera 86
aplres 1111212017
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�' _.ri Cash Register Receipt Receipt Number
City of Atlantic Beach R3304
93L .,
DESCRIPTION I ACCOUNT I QTY I PAID
PermitTRAK $203.00
ERES17-0173 Address: 390 SKATE RD APN: 171667 0000 $109.00
ELECTRICAL $105.00
ELECTRICAL BASE FEE 455-0000-322-1000 0 $55.00
ELEC SERVICE CHANGE 455-0000-322-1000 150 $50.00
STATE SURCHARGES $4.00
STATE DBPR SURCHARGE 455-0000-208-0600 0 $2.00
STATE DCA SURCHARGE 45500002080700 0 $2.00
TEMP17-0031 Address: 357 11th St. APN: $94.00
ELECTRICAL $90.00
ELEC TEMP SERVICE 455-0000-322-1000 0 $35.00
ELECTRICAL BASE FEE 455-0000-322-1000 0 $55.00
STATE SURCHARGES - $4A0.
STATE DBPR SURCHARGE !455-0000-208-0600 0 $2.00
STATE DCA SURCHARGE 45500002080700 0 $2.00
TOTAL FEES PAID BY RECEIPT: R3304 $203.00
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Date Paid: Monday, October 30, 2017
Paid By: KNIGHT ELECTRIC LLC
Cashier: LE
Pay Method: CREDIT CARD 2
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Printed: Monday,October 30,2017 9:04 AM 1 of 1 j14
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