598 CLIPPER SHIP LN ERES19-0021 ELECTRICAL PERMIT ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH
ERES19-0021
800 SEMINOLE ROAD ISSUED: 1/17/2019
9, ATLANTIC BEACH, FL 32233 EXPIRES: 7/16/2019
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL •RK MUST CONFORM T• THE CURRENT • 1 OF •
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: PERMITTYPE: DESCRIPTION: VALUE OF WORK:
598 CLIPPER SHIP LN ELECTRICAL RESIDENTIAL 200 amps/240 volts/single- $800.00
phase - add 2 outlets, switch
TYPE OF
• • GROUP:
170703 0236 SEASPRAY
COMPANY: ADDRESS:--
BEACHES ELECTRIC 214 COKESBURY CT GREEN COVE FL 32043
SERVICES INC. SPRINGS
ADDRESS:®• CITY: STATE: ZIP:
YEAKEL GLENN R 598 CLIPPER SHIP LN ATLANTIC BEACH FL 32233-4113
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 LIGHTING OUTLETS,INCLUDING FIXTURES 4S5-0000-322-1000 2 $1.20
ELEC SWITCH AND RECEPTACLE OUTLETS 455-0000-322-1000 0 $0.60
ELECTRICAL BASE FEE 455-0000-322-1000 0 $55.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 4S5-0000-208-0600 0 $2.00
Issued Date: 1/17/2019 1 of 2
ALL
** INFORMATIONElectrical Permit Application HIGHLIGHTEDIN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
% 800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904)/247-5826 Email: Building-Dept@coab.us PERMIT#:
JOB ADDRESS: c�� � ` l ,P0�.S i\i,2 L nv,% - PROJECT VALUE $ Fsb�•-��
JEA INFORMATION REQUIRED ON ALL PERMITS: 00AMPS01LTS k PHASE
❑ NEW SERVICE: ❑ Overhead ❑Underground ❑Underground up Pole
uResidential (Main) Service:
❑0-100 amps D101-150amps ❑151-200amps ❑ amps #of Meters
iCommercial (Main)Service:
0-100 amps i101-150amps ❑151-200amps ❑ amps ❑CT Service amps
Conductor Type Size
i!.Multi-Family(Main) Service:
❑0-100 amps o101-150amps ❑151-200amps ❑ amps #of Unit Meters
❑ TEMPORARY POLE: amps
❑ SERVICE UPGRADE: ❑ amps ❑CT Service amps
❑ NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.):
100 amps ❑150amps u200amps -- amps -CT Service amps
El 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:
❑ OTHER ELECTRICAL PROJECTS:
❑Swimming Pool Ir iSign ❑Smoke Detectors _(Qty) ❑Transformers KVA ❑Motors HP
❑ FIRE ALARM SYSTEM (Requires 3 sets of plans):
Qty volts/amps
❑ REPAIRS/MISCELLANEOUS:
❑Replace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change DOH to UG
❑Other: Updated 10/17/18
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 provis.ons of any other state or local law regulation construction or the performance of
construction.
Owner Name: 4 `rt e/ ( Phone Number:
Electrical Company: ►, ckj� sJ' CC— S UL Office Phone: /��`� (p Z�'3 I�"L Fax:
Co.Address: ( C c;,V City: C SS State: F-( Zip:
License Holder: d-�o 0o State Certification/Registration#: o2- CSO l�t l Z
Notarized Signature of License Holder
The foregoing instrument was acknowledged befo me this V Ad-ay o bin the State of Florida,County of 0,),V 4A
JENNIFER JOHNSTON Signature of Notary Public -
t£ + ' MY COMMISSION#GG 042984
EXPIRES:october27,2020 [ ] Personally Known OR [a�roduced I entification
orr
Bonded ThruNotary Public Underwrite rs Type of Identification: