1921 SELVA MARINA DR - ELECTRIC REMODEL Tt�T''r ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
J+iii °' CITY OF ATLANTIC BEACH ERES19-0005
r ISSUED:
C----__JV
800SEMINOLEROAD-o� ATLANTIC BEACH. FL 32233 EXPIRES:
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:
1921 SELVA MARINA DR ELECTRICAL RESIDENTIAL ELECTRIC - 12 OUTLETS $8500.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: I GROUP:
SELVA MARINA UNIT
172020 0856 10C
COMPANY: ADDRESS: CITY: STATE: ZIP:
National Electrical 5783 Mining Terrace #6 Jacksonville FL 32257
Contracting LLC
OWNER: ADDRESS: CITY: STATE: ZIP:
WARFLE DAYTON F JR 1921 SELVA MARINA DR ATLANTIC BEACH FL 32233-4519
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 APPLIANCES FIXED OR STATIONERY 45S-0000-322-1000 0 $6.00
ELEC LIGHTING OUTLETS,INCLUDING FIXTURES 455-0000-322-1000 10 $6.00
ELECTRICAL BASE FEE 4S5-0000-322-1000 0 $55.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
Issued Date: 1 of 2
r �i %, ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
tev:i" �� CITY OF ATLANTIC BEACH ERES19-0005
C ISSUED:
800 SEMINOLE ROAD
, ,: � ,
'; - ATLANTIC BEACH. FL 32233 EXPIRES:
LTOTAL: $71.00
Issued Date: 2 of 2
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach,FL 32233
Ph(904)247-5826 Fax (904)247-5845 �Cc (q _ coos
JOB ADDRESS: 012 I 5ek toCc r✓(n A IG- PERMIT# RG'S s-D3g6,
JEA INFORMATION REQUIRED ON ALL PERMITS _200 AMPS )1f0 VOLTS / PHASE
VALUE OF WORK$ �'5.0' o2
❑1 Underground
NEW SERVICE ❑ OverheadTr-Undergroundc'g up Pole
Residential(Main)Service
_:0-100 amps ❑101-150amps V 1-200amps amps #of Meters
Commercial(Main)Service
i..0-100 amps E 101-150am p; C 200amps 2 amps QCT Service amps
Conductor Type Size V
C Multi-Family(Main)Servic•
C0-100 amps E 101-1 Oamps 2151-200amps amps #of Unit Meters
:Temporary Pole amps
SERVICE UPGRADE amps C CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
2:100 amps 7150amps C 200amps :.. amps -CT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 10 0-30amps 31-100amps 101-200amps
Appliances: I 0-30amps I 31-100amps 101-200amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
El Swimming Pool 2 Sign :Smoke Detectors_Qty Transformers KVA _Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
CReplace Burnt/Damaged Meter Can ,Safety Inspection -Panel Change -0H 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 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.
Property Owners Name VfQ(-CI€ Phone Number
Electrical Company 140,4'aha( t(ticir c wl COhi-rtic4n f Office Phone /?oq' clio -08,0 Fax
Co. Address: --)83 rltc `''S (6c(. City G4• State F( Zip 5))c 7
License Holder(Print): Cid YI3 60,-,/' , State Certification/Registration# .6 /3f62)C-76/
Notarized Signature of License Holder
.4.��"" KYESSA GROCE Sworn and subscribed before me di day of hva Yy 20
.7 ;••, Cormnisston#FF 933201 ',,1
g.- ;• Expires November 3,2019 Signature of Notary Public
!��
•.. Niew Da they ire Mnrm.tC0406701i
i1APPfReceipt Number
Cash Register Receipt
„IF City of Atlantic Beach R7769
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $71.00
ERES19-0005 Address: 1921 SELVA MARINA DR APN: 172020 0856 $71.00
ELECTRICAL $67.00
ELECTRICAL BASE FEE 455-0000-322-1000 0 $55.00
ELEC LIGHTING OUTLETS,INCLUDING
455-0000-322-1000 10 $6.00
FIXTURES
ELEC APPLIANCES FIXED OR STATIONERY 455-0000-322-1000 0 $6.00
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: R7769 $71.00
CITY OF ATLANTIC BEACH
800 SEMINOLE RD
ATLANTIC BEAC,Ft.32233
01'07,2019 14:31:07
CREDIT CARD
VISA SALE
Card; XXXXXXXXXXXX1712
SEQ u: 9
Batch : 955
INVOICE 9
Approval Code: 032141
Entry Method: Manual
Mode: Onlne
Tax Amount: $0.00
Card Code: M
SALE AMOUNT ROO
CUSTOMER COPY
Date Paid: Monday,January 07, 2019
Paid By: National Electrical Contracting LLC
Cashier: CB
Pay Method: CREDIT CARD 32141
Printed: Monday,January 07,2019 2:31 PM 1 of 1