2077 Beach Ave ERES18-0348 replace service disconnects permit r ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
C
CITY OF ATLANTIC BEACH ERES18-0348
800 SEMINOLE ROAD ISSUED: 10/29/2018
j ATLANTIC BEACH. FL 32233 EXPIRES: 4/27/2019
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORMTO THE CURRENT 6TH EDITION1 OF • '
CODE, ' OF • 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:
2077 BEACH AVE ELECTRICAL RESIDENTIAL Replace Service Disconnects $1000.00
TYPE OF
ZONING: :D •
CONSTRUCTION: NUMBER: G
169719 0000 NORTH ATLANTIC BCH
UNIT 3
ADDRESS: CITY: STATE: ZIP:
JOHNSON ELECTRIC OF 5025 AZURE ST JACKSONVILLE FL 32258
JACKSONVILLE INC
rATE: ZIP:
• li i, .
SHEPHERD ROBIN W 2077 BEACH AVE ATLANTIC BEACH FL 32233-5934
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 • .
,Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
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: 10/29/2018 1 of 2
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
Ph(904)247-5826 Fax (904) 247-5845 /
JOB ADDRESS: _,)C)-77 $c�c•h 4vc, tA-4/oavt-}•-i c tc,&h 4--L3aa33 PERMIT ``e
JEA INFORMATION REQUIRED ON ALL PERMITS 3c AMPS ---)"0 VOLTS I PHASE
VALUEOFWORK$ /,000.00
NEW SERVICE ❑ Overhead ❑ Underground ❑J Underground up Pole
]Residential (Main)Service
:10-100 amps 11101-150amps ❑151-200amps ❑ amps #of Meters
[_]Commercial (Main)Service
r 10-100 amps [1101-150amps 1_1151-200amps [.]----amps [ICT Service amps
Conductor Type Size
]Multi-Family(Main)Service
[10-100 amps ❑101-150amps [J 151-200amps [l amps #of Unit Meters
[]Temporary Pole [1 amps
SERVICE UPGRADE ❑ amps [1 CT Service— _amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
'[1100 amps 1-1150amps C1200amps 1.1 amps [ICT Service amps
ADDITIONS, REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/SN,.itches: 0-30amps 31-100amps 101-200amps
Appliances: 0-30amps 31-100amps 101-200amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: # circuits ab 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
t;Replace Burnt/Damaged Meter Can :Safety Inspection []Panel Change : :011 to UG
60ther: Rg421a e berth 115-O o,-mp ScvvCc.>° d�secrinersJ-s __
Pennit 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 latow the same to be true and correct. All provisions of laws and ordinances governing this work Ntill be complied with whether
specitieel or not. The permit does not give authority to violate the provisions of am other state or local law regulation construction or the performance of
construction.
Property Owners Name_ }?o b►✓c ��c�-� Phone Number qoy `x71 `43 g`t
Electrical Company Johnson Jc,t-son% \lcf In(--Office Phone 9O't (alto to3tcto Fax
('o. Address: A z Aye- SA. City Jae State ftZip 3a�SFr
License Holder(Print): _ ctrvtJohr\sc State Certification/Registration # t<R I3aiSo k,
Notarized Signature of License Holder
"YC .• DEBRAJOHNSON Sworn a d subscribed before e t s_ day ofLlLgr_____ ________20�
MY COMMISSION#GG 000996
EXPIRES:August 16,2020 Signature of Notary Public
I ;;� .tided 1 hru Notary Pubic Underwriters
9-1
RegisterCash
ofAtlanticBeachR7102
City
DESCRIPTION ACCOUNTCITY PAID
PermitTRAK $94.00
ERES18-0348 Address: 2077 BEACH AVE APN: 169719 0000 $94.00
ELECTRICAL $90.00
ELECTRICAL BASE FEE 455-0000-322-1000 0 $55.00
ELEC REPAIRS AND MISC 455-0000-322-1000 0 $35.00
STATE SURCHARGES $4.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL 'AID BY RECEIPT: R7102 $94.00
CITY OF ATLANTIC BEACH
800 SfNrWic Rd
ATLANTIC B:AC,FL 32233
1018 2018 13:32:37
CREDIT CARD
MC SALE
Card XXXXXXXWB6935
SEQ n: 6
Batch;: 714
INVOICE 6
Approval Code: 05538G
Entry Method: Manual
Mode: Online
Tax Amount: $0,00
Card Code: M
SALE AMOUNT X94,00
CUSTOMER COPY
Date Paid:Thursday, October 18, 2018
Paid By:JOHNSON ELECTRIC OF JACKSONVILLE INC
Cashier: BA
Pay Method: CREDIT CARD 6
Printed:Thursday,October 18,2018 1:35 PM 1 of 1
rnwcr