455 Irex Rd elec permit IS
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
-Oil >�' INSPECTION PHONE LINE 247-5814
ELECTRICAL RESIDENTIAL -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: ERES18-0028
Description: 150 amps/240 volts/single-phase-electrical for remodel
Estimated Value: 800
Issue Date: 1/29/2018
Expiration Date: 7/28/2018
PROPERTY ADDRESS:
Address: 455 IREX RD
RE Number: 171410 0000
PROPERTY OWNER:
Name: Tacoma Properties
Address: 3721 DuPont Station Court South
Jacksonville, FL 32217
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: JAX ELECTRICAL CONTRACTING INC
Address: 1839 LANE AVE SUITE 110 PAUL KEANE
JACKSONVILLE, FL 32210
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$7,500.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach, FL 32233
Ph(904) 247-5826 Fax (904) 247-5845
.TOB ADDRESS: y55 !I-e ,( Rd PERMIT #
JEA INFORMATION REQUIRED ON ALL PERMITS l 5 0 AMPS 2-10 VOLTS PHASE
VAL UE OF WORK$ '5 0 D
NEW SERVICE ❑ Overhead ❑ Underground ED Underground up Pole
[]Residential(Main)Service
00-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Meters
El Commercial(Main)Service
00-100 amps ❑101-150amps ❑151-200amps ❑ amps ❑CT Service amps
Conductor Type Size
❑Multi-Family(Main)Service
00-100 amps ❑101-150amps ❑151-200amps El-amps #of Unit Meters
[]Temporary Pole ❑ amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps 11,150amps ❑200amps ❑ amps ❑CT Service amps
ADDITIONS, MODE ,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Swt 3C 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: /I
OTHER ELECTRICAL PROJECTS
❑Swimming Pool ❑ Sign ❑Smoke Detectors_Qty ❑Transformers KVA ❑Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
❑Replace Burnt/Damaged Meter Can []Safety Inspection ❑Panel Change ❑OH to UG
❑Other:
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 ::I_—a L®Mme.- �c o pe�� t c Phone Number
Electrical CompanyT0_X pecj"e ,( ca"+ i%t c_4,_Q, T n c Office Phone'yg-3 Fax
Co.Address: 20 /7 L aN e-7�,4 ve S City �R��v��,//� State Zip3 ZZ/O
License Holder(Print): rc,„ f KNA^ e Stateertificatio egistration#F 103006'53
Notarized Signature of License Holder
MaW ROMM Sworn and subscribed before me this day of 20 16
Z COMMISSION/R=743
ExPIR�t� 2019 Signature of Notary Public
WWW A"j M
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J'
Receipt Number
�4 Cash Register Receipt
City of Atlantic Beach
' • •
DESCRIPTION • QTY • ,
PermitTRAK $83.60
ERE518-0028 Address: 455 IREX RD APN: 171410 0000 $83.60
ELECTRICAL $79.60
ELECTRICAL BASE FEE 455-0000-322-1000 0 $55.00
ELEC LIGHTING OUTLETS,INCLUDING 455-0000-322-1000 11 $6.60
FIXTURES
ELEC SWITCH AND RECEPTACLE OUTLETS 455-0000-322-1000 0 $18.00
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: R4069 • 1
CITY OF ATLANTIC BEACH
800 SEMINOLE RD
ATLANTIC BEAC,FL 32233
O1/29,12018 13:51;45
CREDIT CARD
VISA SALE
ARD# XXXXXXX)0000t6661
INVOICE 0008
SEQ#: 0007
W#: 000724
Approval Code: 155619
Enty Method: Manual
Mode; Online
Tax Amount 1000
Card Code M
SALE AMOUNT 583,60
CUSTOMER COPY
Date Paid: Monday, January 29, 2018
Paid By:JAX ELECTRICAL CONTRACTING INC
Cashier: CB
Pay Method: CREDIT CARD 15569
/%
Printed: Monday,January 29,2018 1:52 PM 1 of 1
TMIGT