971 Amberjack ERES18-0405 ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH ERES18-0405
800 SEMINOLE ROAD ISSUED: 12/3/2018
ATLANTIC BEACH. FL 32233 EXPIRES:6/1/2019
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
CODE, NEC, IPIVIC, 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 maybe 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:
971 AMBERJACK UN ELECTRICAL RESIDENTIAL Electric for Home Addition $12000.00
TYPE OF REALESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
1711730000 ROYAL PALMS UNIT01
COMPANY: ADDRESS: CITY: STATE: ZIP:
National Electrical 5783 Mining Terrace#6 Jacksonville FL 32257
Contracting U-C
OWNER: ADDRESS: CITY: STATE: ZIP:
LUNDGREN ERIK 971 AM BERJACK LN ATLANTIC BEACH FL 32233-4226
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT
IN YOUR PAYING TWICE FOR IMPROVEMENTSTO 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. Containercannot be placed on City right-of�ay.
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
ELEC AIR CONDITIONING CIRCUITS 455-0000 322-1000 0 $5.00
EUECAPPLIANCES FIXED OR STATIONERY 455-0000-322-l" 0 $6.00
ELEC HEAT 455-0000-322-1000 0 $2.00
ELEC UGHTING OUTUETS,INCLUDING FIXTURES 455�322-2000 20 $12.00
ELEC NEW SINGLE FANIILY 455�322-1000 200 $70.00
ELEC SWLCH AND RECEPTACUE OMLETS 455�322-1000 a $0.w
ELECTRICAI.EASE FEE 0 $55MI
Issued Date:12/3/2018 1 of 2
ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH ERES18-0405
800 SEMINOLE ROAD ISSUED: 12/3/2018
ATLANTIC BEACH. FL 32233 EXPIRES: 6/1/2019
STAW DBPR SURCHARGE 455�20&07W I o $2.25
STAW�SIJRCHARGE 455�20�00 1 0 $2600
TOTAL:$154.25
Issued Date:12/3/2018 2 of 2
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach,FL 32233 CIL
Ph(904)247-5826 F�(904)247-5845
JOB ADDRESS: �aih'c' .),rk I "., PERMIT# q0 -S
JEA INFORMATION REQUIRED ON ALL PERMITS _Z-Q 0—AMPS �'1'4/0 VOLTS Or PHASE
VALVEOFWORK$�a Ma
NEW S�RVICE El Overhead E�/Undergraound D'Umler'ground up Pole
—Residential(Main)Service
-0-100 maps 1101-150amps /51-200amps
--Commercial(Main)Service __aaaps #-of Meters
'-0-100amps _101-150amps 151-200amps - amps E.CT Service_maps
Conductor Type_ Sim—
�:Multl-Family(Main)Service
- 0-100 maps 01��.150amps 0 151-200amps [,_____amps #of Unit Meters
Aemporiary Pole 11_j��annps
SERVICE UPGRADE -.1—amps L CT Service_maps
NEW FEEDER(ADDITIONS,ACCESSgRY STRUCTURES,ETC.)
100amps �1150&nnps _nWamps L_Mps :ICT Service_maps
ADDITIONS,REMODELS REPAIRS,BUILD'OM ACCESSORY STRUCTURES,ETC.
Outlets/Switches: nro-30amps 31-10(hamps —10 1-200amps
Appliances: W 0-30amps 31-100amps —101-200amps
AJC Circuits: 7-0-60amps 61-100amps
Heat Circuits: 9 circuits kw
Number of Lighting Outlets, Including Fixtum_s.7
OTHER ELECTRICAL PROJECTS
.1 Swimming Pool Sign _Smoke Detectors_Qty _--T=sfmmers_KVA :1Motms_hp
FIRE ALARM SYSTEM (Requires 3 sets of plan)
Qty—volts/amps— VALUE OF WORKS
REPAIRS/MISCELLANEOUS
Replace,BurinfDamaged Meter Can :]Safety Inspection �:Panell Change �IOHWUG
4,W, qj V11 Yt-XI, C;k CrOA.
Permit bow..void if work does not ctmcomo�within a sl�Month Period or work is suspended or obandc ,that I have
mad this application and know the same to be me and carrect. Ail provisions of laws and ordinances governing this work will be complied with whether
specified or not The perout do"not give authomy to violate the provisims of my other state or local law regulation construction of the palboomem,of
constroctio..
Property Owners Name Phone Number
Electrical Company k1c,
J�j �'"-Cj �Office Phone ax—
State
Co. Address: .15^79'3 co 5 0' City d"I 7(, _a�ziv ?2'�A
License Holder(Print): State Certification/Registration#
Notarized Signature ofLicense Holder
Swam and subscribed before me t day of NIL
,aflr
MADISOMPELLICER i M�� )I.0 � LU I
Cornmismn#GG195in Signature of Notary Publ
Ecomsuamb12,2022
Cash Register Receipt Receipt Number
City of Atlantic Beach R7512
7 1
Address: 971 AMBERJACK LN APN: 171173 0000 $154.
L $150.00
ELEC AIR CONDITIONING CIRCUITS 455 0000-322-1000 0 $5.00
ELEC APPLIANCES FIXED OR STATIONERY 455-0000-322-1000 0 $6.00
ELEC HEAT 455-0000-322-1000 0 $200
ELEC LIGHTING OUTLETS,INCLUDING 455-0000�322-1000 20 $12.OD
FIXTURES
FLEC NEW SINGLE FAMILY 455-0000-322-IOOD 200 $70.00
ELECTRICAL BASE FEE 455-0000-322-1000 0 $55.00
STATE SURCHARGE $4.25
STATE DBPR SURCHARGE 5 1100 211 1 D $2.25
D000_';0700
STATE DCA SURCHARGE ��451M $2.00
TOTAL FEES PAID BY RECEIPT: R7512 $154.25
Perm AK
it!!—
ERES18-0405 21
ELECTRICA
Date Paid: Monday, December 03, 2018
Paid By: National Electrical Contracting LLC
Cashier: BA
Pay Method; CREDIT CARD 4
Pilinted:Monday,December 03,2018 2:13 PM I of 1 It