2217 ALICIA LN - ELECTRIC METER CAN I
, LA41.71- ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
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v. ERES18-0354
CITY OF ATLANTIC BEACH
ISSUED: 10/22/2018
A ti
�v Jf;�,� 800 SEMINOLE ROAD EXPIRES:4/20/2019
ATLANTIC BEACH. FL 32233
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORM TO THE CURRENT 6TH EDITION (2017) OF THE FLORIDA BUILDING
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
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.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
2217 ALICIA LN ELECTRICAL RESIDENTIAL REPLACE BURNT METER CAN $2400.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: " NUMBER: GROUP:
169519 0760 TIFFANY BY THE SEA
COMPANY: ADDRESS: CITY: STATE: ZIP:
AMERICAN ELECTRICAL 5065 ST AUGUSTINE RD APT 13 JACKSONVILLE FL 32207
CONTRACTOR
OWNER: ADDRESS: CITY: STATE: ZIP:
MASHOD SIAMAC 2217 ALICIA LN ATLANTIC BEACH FL 32233-5975
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT
IN YOUR 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.
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
ELEC REPAIRS AND MISC 455-0000-322-1000 0 $35.00
ELECTRICAL BASE FEE 455-0000-322-1000 0 $55.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $94.00
Issued Date: 10/22/2018
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
Ph(904)247-5826 Fax (904)247-5845 ERGS(8 b-S Ste/
JOB ADDRESS: z-7- \ 1 ' \ C\ C Lan C PERMIT# T
JEA INFORMATION REQUIRED ON ALL PERMITS .40(-) _AMPS 2.IA D VOLTS a. PHASE
00
VALUE OF WORK$ 2�VQ+
NEW SERVICE 0 Overhead Underground ❑I Underground up Pole
❑Residential(Main)Service
❑0-100 amps ❑101-150amps 151-200amps 1 i amps #of Meters
❑Commercial(Main)Service
00-100 amps ❑101-150amps L 151-200amps Li amps OCT Service amps
Conductor Type Size
❑Multi-Family(Main)Service
❑0-100 amps ❑101-150amps H 151-200amps r amps #of Unit Meters
❑Temporary Pole LI amps
SERVICE UPGRADE ❑ amps U CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps ❑150amps 0200amps ❑ 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 ❑ 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 TI Safety Inspection ❑Panel Change OH to UG
I '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. �,/� \\A
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Property Owners Name 1 1 L C 1 \af-N-\C)c;\ Phone Number(. O`� 1 � 1
Electrical Company VA`'kl n E\ C,--\\--- \Ca,\ Office Phone 31-1 I 1 C) Fax
Co.Address:-D lap . iv 0 . ; ` l- r" C L+Ly- - Jfl I\ tate=I_ Zip'32)0
License Holder (Print): 1 .\C, YA o --‘—‘9,- a Certification/Registration# t..�� , ,„ ,
Notarized Signature off License Holder tf,/
ng'M.Day �
y4,104-cisNTOTTAERY PUBLICSworn and subscribed b:r • . e this+ r0— day • �1 20 Lb
� AOFFLORIDAc.It •
',. . Comm#GG068924 Signature of Notary Publ ' 0\ B
1.. Expires 2/2/2021 - 41111