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283 BELVEDERE ST - ELECTRIC 004t CITY OF ATLANTIC BEACH 21 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 1;01'7 1 10 iS+PECTION PHONE MaRlig 247-584 ELECTRICAL.RESIDENTIAL - MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 PERMIT INFORMATION: PERMIT NO: ERES17-0185 Description: .: - NEW SERVICE 150 AMPS, 240 VOLTS,SINGLE PHASE Estimated Value: 0 Issue Date: 11/9/2017 Expiration Date: 5/8/2018 PROPERTY ADDRESS: Address: 283 BELVEDERE ST RE Number 170502 0000 PROPERTY OWNER: :. . Name: :: HOGAR COMMUNITY REINVESTMENT Address:::.. GENERAL CONTRACTOR INFORMATION: Name:_ Address: Phone: Name: SCHUMAN ELECTRIC INC. Address:. PO BOX 4817.1 QA JOHN JASPER SCHUMAN JACKSONVILLE, FL 32247 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$7,500:: Oct. 17, 2017 11 : 39AM No 49.97 F.r. 1 ELECTRICAL A P IeCti F=y trAr L PERMIT APPLICATION ;�•;; ,r m m� CITY OF ATLANTIC BEACH cin; •: . . , . , . . :'•"'.' ;'. 800'.Seminole.Rd,Atlantic'Beach,FL 32233•' .. •.'. .` b'- ,ô 1l 24 -5826 Fax(904)247-5845M1' Ph(904) 7 e,-;.`g.,., :: ,. ., ■ Jog AIIhRESS•: . . . .9... . .-_..... (). . 5 . . . .... . ..... .... ..... ' 0.. . ELI�tSI -01 JEA INFORMATION REQUIRED ON ALL PERMITS 1550 AMPS E go VOLTS I PHASE VALUE OF WORK$ /600.60 NEW SERVICE E Overhead VII Underground n1 Underground up Pole ❑Residential(Main)Sery' e 00-100 amps kf01-150amps ❑151-200amps 0 amps #of Meters 1 (Commercial(Main)Service 00-100 amps ❑101-150amps ❑151-200aaaps Ci amps • OCT Service amps Conductor Type Size ❑Multi-Fara ly(Main)Service _- _00-100 amps ❑101-150amps, n 151-200amps 0 amps #of Unit Meters ,temporary Pole ❑_ ____ amps SERVICE UPGRADE 0 amps U CT Service amps NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.) • ❑100 amps 0 150amps 0200amps 0 amps OCT Service amps ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC. Outlets/Switches: _ 0-30amps 31-100amps . , . 101-200amps Appliances: 0-3 Oamps 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 Cl Sign 0 Smoke Detectors_Qty 0 Transformers ICVA °Motors hp FIRE ALARM SYSTEM (Requires 3 sets of plans) Qty volts/amps VALUE OF WORK$ REPAIRS/MISCELLANEOUS 0 Replace Burnt/Damaged Meter Can LiSafety Inspection (Panel Change ❑OH to UG Cl Other: J%, tY • fltW house 11--- - 11111M.1111 ‘ 111.11MEMEMME -- r Permit becomcs void if work does not commence within a six month period or work is suspended or abandoned for six months. I hereby eertiry that I have read this application and know the same to be true and correct. AU 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. //�� k--k. GA 2 v� . o ran•rv\v o.3�� -�� KE tv4�C 1 G'rmG--,.� Property Owners Name AlyI YiCO,f CICtS5 1C f'OYY1.C.S Phone Number_ 1' 6'3Q8 Electrical Company_50a 115:1; , 1P 1Y: C Office Phone 737-qiii0 Fax Seg'Ilia/ Co.Address: p 6 Exit-C 48f I City JO.X State Ft Zip 52v45) License Holder(Print): t;J81(if . c rl man /74- ' State Certification/Registration# EC. !3a Notarized Signature of License Holder (...... -----t_.„-----.; """' NOLL* WALDEN �h , '" "' 'r. Sworn and subscribed before me thi day of 3c4 0$ �' _20)7 i': '�' a MY COMMISSION#G0444409 7'"•t EXPIRES November 25,2020 Signature of Notary Public ='Ple-c4Cash Register Receipt Receipt Number City of Atlantic Beach R3412 DESCRIPTION ACCOUNT QTY PAID PermitTRAK $119.00 ERES17-0185 Address: 283 BELVEDERE ST APN: 170502 0000 $119.00 ELECTRICAL $115.00 ELECTRICAL BASE FEE 455-0000-322-1000 0 $55.00 ELEC NEW SINGLE FAMILY 455-0000-322-1000 150 $60.00 STATE SURCHARGES $4.00 STATE DBPR SURCHARGE 455-0000-208-0600 0 $2.00 STATE DCA SURCHARGE 45500002080700 0 $2.00 TOTAL FEES PAID BY RECEIPT: R3412 $119.00 Date Paid:Thursday, November 09, 2017 Paid By: HOGAR COMMUNITY REINVESTMENT Cashier: LE Pay Method: CREDIT CARD 007921 Printed:Thursday,November 09,2017 11:05 AM 1 of 1 104