1050 Mayport Rd elec breaker permit i , yf
CITY OF ATLANTIC BEACH
r ' 800 SEMINOLE ROAD
f
J .
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
ELECTRICAL COMMERCIAL OR MULTIFAMILY DETAILS PER BLDG PLANS -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: ELPP18-0007
Description: 200 amps/240 volts/third-phase - breaker change
Estimated Value: 175
Issue Date: 2/14/2018
Expiration Date: 8/13/2018
PROPERTY ADDRESS:
Address: 1050 MAYPORT RD
RE Number: 170778 0000
PROPERTY OWNER:
Name: FIRST BAPTIST CHURCH OF ATLANTIC BEACH INC
Address: 1050 MAYPORT RD
ATLANTIC BEACH, FL 32233-3432
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: R & R ELECTRIC COMPANY
Address: P O BOX 60665 P.O. BOX 60665
JACKSONVILLE, FL 32236
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.
NOTICE: In addition to the requirements of this permit, there may be additional restrictions
applicable to this property that may be found in the public records of this county, and there may
be additional permits required from other governmental entities such as water management
districts, state agencies, or federal agencies.
* A notice of Commencement is only required for work exceeding an estimated value of
$2,500. For I-IVAC work, a Notice of Commencement is only required when HVAC work
exceeds and estimated value of$7,500.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach,FL 32233 Qn
r Ph(9904+) 247-5826 Fax (904) 247-5845
JOB ADDRESS: �5 l�G�(,;�_j� Y�' 1�-�t PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS .AMPS VOLTS Z-PHASE
VALUE OF WORK$ 1-16 L1(1
NEW SERVICE Overhead ❑ Underground EDUnderground up Pole
OResidential(Main)Service
10-100 amps 0101-150amps 0151-200amps 0 amps #of Meters
0 Commercial(Main)Service
110-100 amps ❑101-150amps 151-200amps ❑ amps OCT Service amps
Conductor Type Size
0 Multi-Family(Main)Service
❑0-100 amps 0101-150amps 151-200amps 0-amps #of Unit Meters
[_]Temporary Pole 0 amps
SERVICE UPGRADE [.1 amps CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps ❑150amps 11200amps ❑ amps OCT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 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:
OTHER ELECTRICAL PROJECTS
❑Swimming Pool 0 Sign OSmoke Detectors_Qty ❑Transformers KVA G,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 OOH to UG
t ther: 6l`-O4` i CkRYt t�ev fb V JAP w ftIC, Lt,ti I t�
Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months. 1 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�YS_�S� UAi{V rel p f 14adl(' 1 e0(4'1 Phone Number qq), SSD
Electrical Company x lai( i 1 C C �lOr V� �_ Offic-eT Phone
r�l04 5555 Fax
Co.Address: ` J City �I0_CU-SUn� ;M.Q State p- Zip 3aa{s(o
License Holder(Print): Tzobe,4 +i� State Certification/Registration#
Notarized Signature of License Holder G[ 6 (
KAREN G HENDERSO3r 'worn and subscribed before me his ,/ y day of T e,� 20_
MY COMMISSION N 0009026
EXPIRES March 07,2021 gnature of Notary Public
i
y
Cash Register Receipt Receipt Number
J yr
City of Atlantic Beach I I
DESCRIPTION • CITY PAID
PermitTRAK $109.00
ELPP18-0007 Address: 1050 MAYPORT RD APN: 170778 0000 $109.00
ELECTRICAL $105.00
ELECTRICAL BASE FEE 455-0000-322-1000 0 $55.00
ELEC SERVICE CHANGE 455-0000-322-1000 200 $50.00
STATE SURCHARGES $4.00
STATE DBPR SURCHARGE 455-0000-208-06000 $2.00
STATE DCA SURCHARGE 45500002080700 0 $2.00
'TOTAL •41 . 11
CITY OF ATLANTIC BEACH
800 SEMINOLE RD
ATLANTIC BEAC,FL 32233
02;14/2016 15:06:39
CREDIT CARD
VISA SALE
BARD# XXXXXXXXXXXX0061
:INVOICE 0005
SEQ#: 0005
Batch#: 000736
Approval Code: 014313
Enty Meftd: Manual
INode: Online
'Tax Amount: ;0.00
Card Code: M
SALE AMOUNT X109,00
CUSTOMER COPY
Date Paid: Wednesday, February 14, 2018
Paid By: R & R ELECTRIC COMPANY
Cashier: CB
Pay Method: CREDIT CARD 014313
00I
Printed: Wednesday, February14,2018 3:13 PM 1 of 1 1
TRAK,T