1835 SEMINOLE RD ERES19-0027 ELECTRICAL PERMIT ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH
ERES19-0027
800 SEMINOLE ROAD ISSUED: 1/23/2019
- ATLANTIC BEACH. FL 32233 EXPIRES: 7/22/2019
MUST CALL INSPECTIONPHONE • 1 i 247-5814 BY 4 PM FOR NEXT DAY • •
ALL • ' K MUST CONFORM TO THE CURRENT 6TH EDITION1 OF • ' D+ BUILDING
CODE, ' AND OF ATLANTIC + CH 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:
1835 SEMINOLE RD ELECTRICAL RESIDENTIAL ELECTRIC -A/C CIRCUIT $600.00
TYPE OF
ZONING: : � •
• • • •
1696310000 OCEAN GROVE UNIT 02
COMPANY: ADDRESS:
LORE ELECTRICAL 210 N ROSCOE BLVD PONTE VEDRA FL 32082
CONTRACTORS BEACH
OWNER: ADD' STATE:
WATERS JANICE B LIFE 1835 SEMINOLE RD ATLANTIC BEACH FL 32233-5915
ESTATE
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 AIR CONDITIONING CIRCUITS 455-0000-322-1000 0 $5.00
ELEC SWITCH AND RECEPTACLE OUTLETS 455-0000-322-1000 0 $0.00
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
Issued Date: 1/23/2019 1 of 2
ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
ERES19-0027
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD ISSUED: 1/23/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 7/22/2019
TOTAL: $64.00ii
Issued Date: 1/23/2019 2 of 2
ALL
Electrical Permit Application **HIGHLI HIGHLIGHTED
ON
HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 - --S[9 -00 Z_7
Phone: (904) 247-5826 Email: Buildin -De t @ coab.us PERMIT#:
JOB ADDRESS: S z'/tl �= �`�- PROJECT VALUE $ �&D
JEA INFORMATION REQUIRED ON ALL PERMITS: Zg� AMPS f' ' VOLTS PHASE
❑ NEW SERVICE: i Overhead ❑Underground ❑Underground up Pole
i iResidential (Main)Service:
0-100 amps o101-150amps ❑151-200amps ❑ amps #of Meters
Commercial (Main) Service:
❑0-100 amps o101-150amps ❑151-200amps ❑ amps ❑CT Service amps
Conductor Type Size
iMulti-Family(Main) Service:
0-100 amps 101-150amps o151-200amps ❑ amps #of Unit Meters
❑ TEMPORARY POLE: amps
❑ SERVICE UPGRADE: amps ❑CT Service amps
❑ NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.):
r 1.00 amps i 150amps 200amps amps ❑CT 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:
❑ OTHER ELECTRICAL PROJECTS:
❑Swimming Pool ❑Sign ❑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 ❑OH 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 provisions of any other state or local law regulation construction or the performance of
construction.
Owner Name: /X / I GL v—S Phone Number:
Electrical Company: c E V.T'IsCi ice Phone: Fax: 3,-
Co.Address: C — ��Oc� City: L/�d/�a 4//State—/// : Zip: 30bF2_
License Holder: // State Certification/Registration#: / 3 D&6 9L—
Notarized Signature of License Holder
The foregoing instrument was acknowledged before me this Z,.3ay of 20gn the State^of Florida,Cou y of
Signatu of Notary Public
Fl -�"
` r0l'l1GINDLESPERGER fvi or',tiSSIONFF9pa951 ersonally Known OR[ ] Produced Identification
wry Culober 6,2019 Type of Identification:
3:. ..o 4,u ilotary public Underwriters