340 W 14th St safety inspection permit CITY OF ATLANTIC BEACH
SS1
a' 800 SEMINOLE ROAD
�r ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
ELECTRICAL RESIDENTIAL -
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
PERMIT INFORMATION:
PERMIT NO: ERES18-0163
Description: 150 amps/240 volts/single-phase-safety inspection
Estimated Value: 300
Issue Date: 5/22/2018
Expiration Date: 11/18/2018
PROPERTY ADDRESS:
Address: 340 W 14TH ST
RE Number: 171059 0000
PROPERTY OWNER:
Name: MANDARIN MANAGEMENT SYSTEMS INC
Address: 13690 LONGS LANDING RD W
JACKSONVILLE, FL 32225
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: National Electrical Contracting LLC
Address: 5783 Mining Terrace Suite 6
Jacksonville, FL
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 HVAC work, a Notice of Commencement is only required when HVAC work
exceeds and estimated value of$7,500.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach,FL 32233
�/,, 1,+ Ph(904)247-5826 Fax(904)247-5845 .£
JOB ADDRESS: 3T' W' 1 +-4 �� PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS SAMPS VOLTS ( PHASE
VALUE OF WORK$ �?69 0
NEW SERVICE ❑ Overhead ❑ Underground ❑1 Underground up Pole
^Residential(Main)Service
?0-100 amps 101-150amps 151-200amps amps #of Meters
Commercial(Main)Service
0-100 amps401-150amps i._151-200amps _ amps DCT Service amps
Conductor Type Size
-,Multi-Family(Main)Service
A-100 amps 101-150amps 151-200amps (; amps #of Unit Meters
Temporary Pole 2 amps
SERVICE UPGRADE amps = CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
100amps 150amps C200amps _ amps -CT 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 `_ Sign Smoke Detectors_Qty Transformers KVA -,Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REP AIRS/MISCELLANEOUS
Replace Burnt/Damaged Meter afety Inspection -?P el Change OH to UG
Other:
Permit becomes void if work dors 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 gay"
Phone Number
Electrical Company /I/cd� � �'`t ( �^�" '� Ldp Office Phone 54,0s�
Fax i
Co.Address: 571 „ ;,,;,, ` Qrr> r-c S , City 3,--/
- State/cL- zip Z2 S 7
arra2-,
License Holde �1' } ., ', r7s C7 y State Certification/Registration 4 ft4'301 S3'67/
Notari a
z
P,sjL f;ge Holder -
EXg '.Q
75 Sworn and subscribed before me Shi '' r da of 20
Signature of Notary Public /
CV
"0 aor City of Atlantic Beach R5141
Cash • • • • • • • . • • •
DESCRIPTION ACCOUNTQTY PAID
PermitTRAK $109.00
ERES18-0163 Address: 340 W 14TH ST APNI: 171059 0000 $109.00
ELECTRICAL $105.00
ELECTRICAL BASE FEE 455-0000-322-1000 0 $55.00
SAFETY INSPECTION 455-0000-322-1000 0 $50.00
STATE SURCHARGES $4.00
STATE DBPR SURCHARGE 455-0000-208-0600 0 $2.00
STATE DCA SURCHARGE 45500002080700 0
TOTAL , $109.00
CITY OF ATLANTIC BEACH
800 SEMINOLE RD
ATLANTIC BEAC,FL 32233
05j22?201B 13:50:04
CREDIT CARD
VISA SALE
Card# XXXXXXXXXXXX2572
SEQ#: 1
Batch#: 611
INVOICE 1
Approval Code: 081031
Entry Method: Manual
Mode: Online
Tax Amount; $0.00
Card C,,de: M
SALE AMOUNT $S00
CUSTOMER COPY
Date Paid: Tuesday, May 22, 2018
Paid By: National Electrical Contractin
Cashier: BA
Pay Method: CREDIT CARD 7
Printed:Tuesday, May 22,2018 1:51 PMI1 of 1
TNAKiT