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750 Sailfish ERES18-0256 CITY OF ATLANTIC BEACH _ 800 SEMINOLE 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: ERES18-0256 Description: ONE OUTLET FOR CAMPER Estimated Value: 200 Issue Date: Expiration Date: PROPERTY ADDRESS: Address: 750 SAILFISH DR RE Number: 171205 0000 PROPERTY OWNER: Name: SMITH DEBORAH A ET AL Address: 750 SAILFISH DR ATLANTIC BEACH, FL 32233 GENERAL CONTRACTOR INFORMATION: Name: Address: Phone: Name: Address: 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$7,500. ELECTRICAL PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd, Atlantic Beach, FL 32233 Ph(904)247-5826 Fax(904)247-5845 Jos ADDREss:��(� SA 1 ��le �Q\y� PERMIT# JEA INFORMATION REQUIRED ON ALL PERMITS AMPS VOLTS PHASE O� VALUE OF WORKS QIfn- NEW SERVICE ❑ Overhead ❑ Underground ❑t Underground up Pole ❑Residential(Main)Service 00-100 amps F1101-150amps 0151-200amps ❑ amps #of Meters ❑Commercial(Main)Service E10-100amps L1101-150amps 0151-200amps II amps IICT Service amps Conductor Type Size ❑Multi-Family(Main)Service ❑0-100 amps 0101-150amps 11151-200ant ❑ amps #of Unit Meters ❑Temporary Pole ❑ amps SERVICE UPGRADE ❑ amps ❑ CT Service amps NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.) ❑100 amps ❑150amps 0200amps Damps ❑Cr Serviceamps ADDITIONS,REMODELS,REPAIRS,BULD-OUTS,ACCESSORY STRUCTURES,ETC. Outlets/Switches: 0-30amps 31-100amps 101-200amps Appliances: 0-30amps 31-100amps 101-200amps A/C Circuits: 0-60amps 61-100amps Heat Circuits: # circuits @ kw Number of Lighting Outlets, Including Fixtures: OTHER ELECTRICAL PROJECTS ❑Swimming Pool ' Sign ❑Smoke Detectors_Qty ❑Transformers KVA ❑Motors hp FIRE ALARM SYSTEM (Requires 3 sets of plans) Qty_volts/amps VALUE OF WORK$ REPAIRS/MISCELLANEOUS ❑Replace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change ❑OH to UG ❑Other: Tnn E-- n an,v PQM 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 1 have read this application and know,the same to be true and comect 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 consm otion or the performance of construction. /� , 1 Property Owners Nam�C; � N S rn 1 �Y'A 1 Phone NumberRCN QQ Electrical Company Office Phone Fax Co.Address: City State Zip License Holder(Print Sttate Certifieation/Regi . stration# Notarized Signature of License Hold Sworn and subscribed before m }is of 20(6 TMrWMMIS IsION0 FFF 924951 # EXPREs.October 6,W19 Signature of Notary Public q! u„aoarnn rnary roue uaxrmn o CITY OF ATLANTIC BEACH (OWNER/ BUILDER AFFIDAVIT gY I. FLORIDA STATUTES; CHAPTER 489, FLORIDA STATUTES, PART 1 'CONSTRUCTION CONTRACTING"REQUIRES OWNER/BUILDER TO ACKNOWLEDGE THE LAW: DISCLOSURE STATEMENT FOR SECTION 489.103(7),FLORIDA STATUTES: STATE LAW REQUIRES CONSTRUCTION TO BE DONE BY LICENSED CONTRACTORS. YOU HAVE APPLIED FOR A PERMIT UNDER AN EXEMPTION TO THAT LAW. THE EXEMPTION ALLOWS YOU,AS THE OWNER OF YOUR PROPERTY,TO ACT AS YOUR OWN CONTRACTOR EVEN THOUGH YOU DO NOT HAVE A LICENSE. YOU MUST SUPERVISE THE CONSTRUCTION YOURSELF YOU MAY BUILD OR IMPROVE A ONE—OR TWO FAMILY RESIDENCE OR A FARM OUTBUILDING. YOU MAY ALSO BUILD OR IMPROVE A COMMERCIAL BUILDING AT A COST OF 525,000.00 OR LESS. TEE BUILDING MUST BE FOR YOUR USE AND OCCUPANCY. IT MAY NOT BE BUILT FOR SALE OR LEASE. IF YOU SELL OR LEASE A BUILDING YOU HAVE BUILT YOURSELF WITHIN ONE YEAR AFTER THE CONSTRUCTION IS COMPLETE,THE LAW WILL PRESUME THAT YOU BUILT IT FOR SALE OR LEASE,WHICH IS IN VIOLATION OF THIS EXEMPTION. YOU MAY NOT HIRE AN UNLICENSED PERSON AS YOUR CONTRACTOR. YOUR CONSTRUCTION MUST BE DONE ACCORDING TO THE BUILDING CODES AND ZONING REGULATIONS. IT IS YOUR RESPONSIBILITY TO MAKE SURE THAT PEOPLE EMPLOYED BY YOU HAVE LICENSES REQUIRED BY STATE LAW AND BY COUNTY OR MUNICIPAL LICENSING ORDINANCES. U. INJURY LIABILITY; SINCE OWNERS MAY BE LIABLE FOR INJURIES TO WORKERS THEY HIRE, THE BUILDING DEPARTMENT SUGGESTS WORKER'S COMPENSATION INSURANCE BE PURCHASED. III. IRS WITHHOLDING; OWNERS HIRING WORKERS BECOME EMPLOYERS AND SHOULD ALSO OBSERVE IRS WITHHOLDING TAX AND/OR FORM 1099 REQUIREMENTS ON THE WORKERS THEY EMPLOY ON THEIR IMPROVEMENT TRADES. IV. PENALTY; UNLICENSED CONTRACTORS CANNOT BE EMPLOYED UNDER ANY CIRCUMSTANCES. OWNERS BEING SUBJECT TO$5,000 PENALTY UNDER FLORIDA STATUTE NO. 455-228(1). AN-OCCUPATIONAL LICENSE' IS NOT ADEQUATE. THE OWNER SHOULD PHYSICALLY SEE THE COUNTY 'CERTIFICATE OF COMPETENCY" OR THE FLORIDA 'CONTRACTORS CERTIFICATE' TO ASCERTAIN IF A PERSON IS A LICENSED CONTRACTOR. TELEPHONE THE BUILDING DEPARTMENT(247-5826)IF IN DOUBT. V.ACKNOWLEDGEMENT; I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE DISCLOSURE STATEMENT AND THAT I COMPLY WITH ALL THE REQUIREMENTS FOR THE ISSUANCE OF AN OWNER-BUILDER PERMIT. `ZSr„ sq��j�1��0�✓9 U f71n0�� MORESS �NET�E� T TNR DA Betas ma tllbta eeyM "-' 30(�rOa tlro wunry ar Nu.l,Stats M Rode.,llaspare._ ly ap nq MmeaM/hexHaM Mmla Nat aaelatemeMe and aaaamion ar "ane m. Notary uEIIC t Lame.Smea OLK County or rJ ✓Co✓C Ily KnwnA ❑Ptmaredlaemereuony TOAMGIgOUBPEgGEq ExCI'll 10NtfF824961 ' de E%PIgEB:Oplpeer 6,21119 NWery SiBnaWre: R.1:« Banhtl Thm%"PutiUeee a F iBLDCIOw.mauilhe PReEent�REVISBD'.YlalaK