1823 ATLANTIC BEACH DR - POOL ELECTRIC '--",!:1-i:-/--•,-,_ ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
h. �`
ACITY OF3ATLANTIC BEACH ERES18-0418
^` ' ',. .fs? 800 SEMINOLE ROAD EXPIRES: 6/16/2019
-'-'% ISSUED: 12/18/2018
�.3»/ 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: i VALUE OF WORK:
1823 ATLANTIC BEACH DR ELECTRICAL RESIDENTIAL electric for swimming pool $600.00
d TYPE OF REAL ESTATE BUILDING USE
ZONING: SUBDIVISION:CONSTRUCTION: NUMBER: GROUP:
ATLANTIC BEACH
169505 1520 COUNTRY CLUB UNIT 02
COMPANY: ADDRESS: CITY: STATE: ZIP:
DAVID PRUETTES 331 -8 P PARKRIDGE AVE ORANGE PARK FL 32065
ELECTRICAL SVC.
OWNER: ADDRESS: CITY: STATE: ZIP:
David Shields 1823 Atlantic Beach Dr Atlantic Beach FL 32233
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.
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DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
ELEC SWIMMING POOLS
455-0000-322-1000 0 $40.00
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: $99.00
Issued Date: 12/18/2018 1 of 2
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233 S(g _ �� '
Ph(904)247-5826 Fax (904)247-5845 6,
JOB ADDRESS: ti a3 Rk-kw rtC,-gecio 1 PERMIT#h\ 18•oOEPI
JEA INFORMATION REQUIRED ON ALL PERMITS AMPS VOLTS PHASE
VALUE OF WORKS 00.C0
NEW SERVICE ❑ Overhead ❑ Underground ❑T Underground up Pole
❑Residential(Main)Service
00-100 amps ❑101-150amps a 151-200amps 0 amps #of Meters
0 Commercial(Main)Service
00-100 amps ❑101-150amps 0 151-200amps 0 amps OCT Service amps
Conductor Type Size
0 Multi-Family(Main)Service
0-100 amps C 101-150amps 0151-200amps n amps #of Unit Meters
:Temporary Pole E l amps
SERVICE UPGRADE 0 amps 0 CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
,100 amps 0 150amps 200amps 0 amps DCT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-30amps 31-100amps 101-200amps
Appliances: 0-30amps 31-100amps 101-200amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
OTHE LECTRIC.AL PROJECTS
__Swimming Pool C Sign P Smoke Detectors Qty 7Transformers KVA LJMotors hp -
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
UReplace Burnt/Damaged Meter Can .Safety Inspection ❑Panel Change ❑OH to UG
❑Other:
°ermit becomes void if work does not commcncc within a six month period or work is suspended or abandoned for six months. I hereby certify that I have
-ead 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
;pecified 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
;onstruction.
?roperty Owners Name o S - Phone Number �c —�
:lectrical Company�t rZ e#16.S aednatJ 6 r C• Office Phone �7p�'�7? J Fax R70-1
-064.5
:o. Address: 33 1 - a PCLyiçç/ ICi te La, Sated Zip i�.icense Holder(Print) �J( P - ,i ./ leer
e a ion g"station# 5=22
Votarized Signature of License Holder / _'t>RV
lit:��,jy'i� CHO ROBERTS Before me this l ll day of 20 k
;i4• Notary Public-State of Florida k
��
'.. • Commission N GG 211925 Signature of Notary Public
?or wd7 My Comm.Expires Aug 21,2022
Bonded through National Notary Assn.
SrT�'lfin
^' Cash Register Receipt Receipt Number
"� City of Atlantic Beach R7647
Lo.i >r
DESCRIPTION I ACCOUNT I QTY I PAID
PermitTRAK $99.00
ERES18-0418 Address: 1823 ATLANTIC BEACH DR APN: 169505 1520 $99.00
ELECTRICAL $95.00
ELECTRICAL BASE FEE 455-0000-322-1000 0 $55.00
ELEC SWIMMING POOLSi 455-0000-322-1000 0 $40.00
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 FEES PAID BY RECEIPT: R7647 $99.00
Date Paid: Tuesday, December 18, 2018
Paid By: DAVID PRUETTES ELECTRICAL SVC.
Cashier: CB
Pay Method: CREDIT CARD 90625
Printed:Tuesday, December 18, 2018 10:06 AM 1 of 1