67 S FORRESTAL CIR ELEC PERM ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH ERES19-0041
800 SEMINOLE ROAD ISSUED: 1/31/2019
rvt EXPIRES: 7/30/2019
"ulo9" ATLANTIC BEACH. FL 32233
MUST CALL • • • 1 / 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORMTO THE CURRENT 6TH EDITION1 OF • '
CODE, OF BEACH CODEOF • '
ALL CONDITIONS OF • 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:
200 amps/240 volts/single-
67 S FORRESTAL CIR ELECTRICAL RESIDENTIAL phase - circuit for water $0.00
heater
TYPE OF
ZONING: :D •
• • GROUP:
171734 0000 4TLANTIC BEACH VILLA#
01
COMPANY: ADDRESS,
STATE-
R & R ELECTRIC COMPANY P 0 BOX 60665 JACKSONVILLE FL 32236
• ADDRESS:
Ross Fanti 67 S Forrestal Cir 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 • •
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 APPLIANCES FIXED OR STATIONERY 45S-0000-322-1000 0 $2.00
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: 1/31/2019 1 of 2
ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD ISSUED: 1/31/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 7/30/2019
TO
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|sauedDate: 1/]1/2O19 o
ALL
* INFORMATIONElectrical Permit Application HIGHLIGHTED IN
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: 67 Forrestal Cir S PROJECT VALUE $$ 200.00
JEA INFORMATION REQUIRED ON ALL PERMITS: 200 AMPS 240 VOLTS 1 PHASE
❑ NEW SERVICE: D Overhead Mnderground OUnderground up Pole
Mesidential (Main)Service:
00-100 amps 0101-150amps 0151-200amps [_amps #of Meters
OCommercial (Main)Service:
D0-100 amps 0101-150amps 0151-200amps _amps OCT Service amps
Conductor Type Size
OMulti-Family(Main)Service:
130-100 amps 0101-150amps 0151-200amps 0 amps #of Unit Meters
❑TEMPORARY POLE: amps
SERVICE UPGRADE: ❑ amps OCT Service amps
❑ NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.):
[3100 amps 0150amps ❑200amps 0 amps 13CT 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
FV] REPAIRS/MISCELLANEOUS:
❑Replace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change ❑OH to UG
✓❑Dther:Circuit for waterheater 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: Ross Fanti Phone Number: 238-9799
Electrical Company: R&R Electric Of North FL Office Phone: 764-5555 Fax:
Co.Address: PO Box 60665 City: Jacksonville State: FL Zip: 32236
License Holder: Robert A Sallette JR State Certification/Registration#: EC0001318
Notarized Signature of License Holder
The foregoing instrument was acknowledged before me this L dayof 20 q in the State of Florida,County of Diva
9; nature of Notary Public
+' ''• KAREN G HENDERSON
' Personal) Known OR Produced Identification
`- MY COMMISSION*0008026; y � �
or
EXPIRES March 07,2021 T pe of Identification: