341 6th ERES18-0358 ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
rCITY OF ATLANTIC BEACH ERES18-0358
.0 800 SEMINOLE ROAD ISSUED: 10/25/2018
°% v ATLANTIC BEACH. FL 32233 EXPIRES:4/23/2019
MUST CALL INSPECTION PHONE LINE (904) 247-5814
Y 4 PM FOR NEXT DAY INSPECTION.
ALL • • • • • • • • • t OF • • • + 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 aswater management districts,state agencies,orfederal agencies.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
341 6TH ST ELECTRICAL RESIDENTIAL $500.00
ZONING: BUILDING USE
TYPE OF REALESTATE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
169897 0000 ATLANTIC BEACH
COMPANY: ADDRESS:
JEM ELECTRICAL 7219 Capercaillie Th Jacksonville FL 32210
• ADDRESS:
LUCAS JAMES M 341 6TH ST ATLANTIC BEACH FL 32233-5347
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.
DESCRIPTION ACCOUNT QUANTITY PAIDAMOUNT
ELEC LIGHTING OUTLETS,INCLUDING FInURES 455-0000322-1000 0 $ODD
ELEC SWITCH AND RECEPTACLE OUTLETS 455-0000322-1000 0 $2.40
ELECTRICAL BASE FEE 455-0000-322-1000 0 $55.00
STATE DBPRSURCHARGE 455-0000208 0200 0 $100
STATE DCA SURCHARGE 455-0000208-0600 0 $300
TOTAL:$61.40
Issued Date: 10/25/2018 1 of 2
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233 rn��
Ph(904)247-5826 Fax(904)247-5845 jl: v ��—U 358'
JOB ADDRESS: PERMIT# 8-W
JEA INFORMATION.REQUIRED ON ALL PERMITS AMPS VOLTS !✓ PHASE
VALUE OF WORK$ S U
NEW SERVICE ❑ Overhead ❑ Underground ❑1 Underground up Pole
❑Residential(Main)Service
00-100 amps 0101-150amps E1151-200amps ❑ amps #of Meters
❑Commercial(Main)Service
E10-100amps [1101-150amps 0151-200amps ❑ amps ❑CTServiceamps
Conductor Type Size
[]Multi-Family(Main)Service
E10-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Unit Meters
[]Temporary Pole ❑ amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
0100amps 0150amps 13200amps ❑ amps ❑CTService 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: 0
OTHER ELECTRICAL PROJECTS
❑Swimming Pool ❑ Sign ❑Smoke Detectors_Qty ❑Transformers KVA ❑Motorshp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty voltstamps VALUE OF WORKS
REPAIRS/MISCELLANEOUS
❑Replace Bumt/Damaged Meter Can ❑Safety Inspection ❑Panel Change ❑OH to UG
[]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 1 have
read this application and know the same to be we 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.�Am t 5 LlUGCe 5 Phone Number Electrical
�w
Electrical Company V,6 M 54fP �
ICA G Office Phone 37� C�l 7 Fax
Co.Address: 72 t 4f C4 pGYCQ[ (11'c— City yTA?c State Fl. Zip 322(a
License Holder(Print): J74.'r_ f State Certification/Registration# If,13C Isf,01
Notarized Signature of License Holder__ - ZAt r
JPIME D.SMrIH Sworn an subK scribed be me:, 2-S day o 6Cr 201L
rp. WCDM 10110GG25533i
EXP RES:sapumbx5,2022 Signattue of Notary Public
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