149 BEACH AVE ERES19-0028 HVAC CIRCUITS PERMIT ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH ERES19-0028
800 SEMINOLE ROAD ISSUED: 1/24/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 7/23/2019
MUST CALL INSPECTION ' • • 1 + 247-5814 BY + PM FOR NEXT DAY ' •
ALL •RK MUST CONFORM TO THE CURRENT 6TH EDITION1 OF • ' D+ 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:
149 BEACH AVE ELECTRICAL RESIDENTIAL COTTAGE - 2 HVAC ELECTRIC $600.00
CIRCUITS
TYPE OF
i • GROUP:
170214 0000 ATLANTIC BEACH
COMPANY: ADDRESS:
MOORE ELECTRICAL 10526 CRAIG INDUSTRIAL DRIVE JACKSONVILLE FL 32225
CONTRACTORS, INC.
• ADDRESS:
SSR FAMILY LTD ET AL 3300 PHILIPS HWY JACKSONVILLE F1 32207
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 45S-0000-322-1000 0 $10.00
ELECTRICAL BASE FEE 45S-0000-322-1000 0 $55.00
STATE DBPR SURCHARGE 45S-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $69.00
Issued Date: 1/24/2019 1 of 2
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach, FL 32233
Ph(904) 247-5826 Fax (904) 247-5845 C 9 Q
�/
FOB ADDRESS: T 9 Fea_C4A✓ _ PERMIT#
rEA INFORMATION REQUIRED ON ALL PERMITS Q9 AMPS /& y0 VOLTS l PHASE
VAL UE OF WORK$
dEW SERVICE ❑ Overhead ❑ Underground ❑T Underground up Pole
❑Residential(Main) Service
00-100 amps ❑101-150amps ❑151-200amps ❑ amps # of Meters
❑Commercial(Main) Service
00-100 amps 0101-150amps 0151-200amps ❑ amps CCT Service amps
Conductor Type Size
❑Multi-Family(Main)Service
00-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Unit Meters
❑Temporary Pole ❑ amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps ❑150amps 0200amps ❑ 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 @___,fkw
Number of Lighting Outlets, Including Fixtures:
DTHER ELECTRICAL PROJECTS
❑Swimming Pool ❑ Sign ❑Smoke Detectors_Qty ❑Transformers KVA ❑Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans &Fire Alarm Checklist)
Qty volts/amps VAL UE OF WORK S
REPAIRS/MISCELLANEOUS
[]Replace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change OOH 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 goveming 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. Q p
Property Owners Name /� �r/ Phone Number 1 - l 700
Electrical Company It a,-Ided Abd .✓C, OfficePhone&VS—(x$-07 Fax 6 S-4o�?57
Co. Address: Po TO,/ Surd W CityjaLJEgS6&, State// Zip Tc.s
License Holder (Print): JASOYJ U' tate Certificatioil/Registration#iG 60011
Notarized Signature of'License Holder
, Yp, worn a subscribed before merof'A a'�-\
20
?q.•••y�;._ 70NI GINDLESPERGER
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:- MY COMMISSION#FF 924951 gnature of Notary Public
P EXPIRES:October 6,2019
P;;F`.•`` Bonded 7hru Notary Public Underwrmrs