134 Pine St ERES18-0216 CITY OF ATLANTIC BEACH
r
" 800 SENHNOLE ROAD
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: ERES18-0216
Description: 200 Amp 240 Volt Additional Outlets
Estimated Value: 100
Issue Date: 7/2/2018
Expiration Date: 12/29/2018
PROPERTY ADDRESS:
Address: 134 PINE ST
RE Number. 170632 0100
PROPERTY OWNER:
Name: CLOUTIER MARY B
Address: 134 PINE ST
ATLANTIC BEACH, FL 32233
GENERAL CONTRACTOR INFORMATION:
Name:
Address:
Phone:
Name: (REMODEL INC
Address: 4786 N SANDY RUN LN CHRISTOPHER BROCK NEVSETA
JACKSONVILLE, FL 32224
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
Ph(904)247-5826 Fax(904)247-5845 leeS18b22/
JOB ADDRESS: 13 y P,it f S7` PERMIT# 5r
Z'1k n 2.1(e
JEA INFORMATION REQUIRED ON ALL PERMITS 200 AMpS Z Y'q VOLTS y PHASE
VALUEOFWORIf L'OO �TT�
NEW SERVICE ❑ Overhead ❑ Underground E3 Underground up Pole
❑Residential(Main)Service
00-100 amps kl'01-150amps ❑151-200amps ❑ amps #of Meters
❑Commercial(Maio)Service
00-100 amps 11101-150amps 11151-200amps ❑ amps ❑CF Service amps
Conductor Type Sire —
❑Multi-Family(Mala)Service
00-100 amps 11101-150amps E3151-200amps ❑ amps #of Unit Meters
❑Temporary Pok ❑ amps
SERVICE UPGRADE El------amps ❑ Cr Service—amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC)
❑100amps 0150amps ❑200amps ❑ amps ❑CTService—amps
ADDITIONS,REMODELS,REPAIRS,BUH D-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: _�0-30amps 31-I00amps 101-200amps
Appliances: 7.. 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
(]SwimmingPool ❑ Sign ❑Smoke Detectors_Qly ❑Traosfmmers KVA ❑Motors_hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
(2ty—volts/mps VALUEOFWORLS
REPAIRS/MISCELLANEOUS
El Replace Burnt/Damaged Meter Can El Safety Inspection ❑Panel Change ❑OH to UG
❑Other:
P t beeomea idfweak d not eom a wnlun a snc aaean, or work o,saTcuded
Pdtod veaMvensin fors wmdtaw. 1 herebyedwit that Ihe,
read this application and know the same to be true and oorrdA. All pmvisiorm of laws and ordinmces governing this work win be compfidl with whether
specified or not 'Me pemut docs not give authority to violate the provisions ofmy othd state or local law mgulwion c,,,,,,ion m the performance of
constmctian.
Property Owners Name Phone Number
Electrical Company c�/ �-✓n,✓7 E/eeft-✓2� r1 Office Phone 70j'_ 2--, ra, �
Co. Address: 5,Y S Yeo / city Ae, State f
License Holder(Print): 0 SGP fe CettiSCatlon/Registta ' S�
Notarized Signature of License Holdo
Sworn bscribed a
2pg
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Signature of Notary Publ' vd'
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