272 3rd ST - ELECTRIC SAFETY yL">.- ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
I. '- \� ERES19-0067
�::, - , . CITY OF ATLANTIC BEACH
r )3 800 SEMINOLE ROAD ISSUED: 2/22/2019
''-',?'----7_17--_--.);119',- ATLANTIC BEACH. FL 32233 EXPIRES:8/21/2019
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:
272 3RD ST ELECTRICAL RESIDENTIAL SAFETY $250.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
ATLANTIC BEACH
172548 0000 TERRACE
COMPANY: ADDRESS: CITY: STATE: ZIP:
BEACHES ELECTRIC 214 COKESBURY CT GREEN COVE FL 32043
SERVICES INC. SPRINGS
OWNER: ADDRESS: CITY: STATE: ZIP:
ROBERT JACKSON ATLANTIC BEACH FL 32233-5319
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
ELECTRICAL BASE FEE 455-0000-322-1000 0 $55.00
SAFETY INSPECTION 455-0000-322-1000 0 $50.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$109.00
Issued Date:2/22/2019 1 of 2
Electrical Permit Application **ALL INFORMATION
ys=su'�i, r�+ HIGHLIGHTED IN
ri '�
City of Atlantic Beach Building Department GRAY IS REQUIRED.
54 v 800 Seminole Rd, Atlantic Beach, FL 32233 G RES(9 _00(07
F'CMPhone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:
JOB ADDRESS: �—) Z r‘C9 s i- 47 VALUE$ -7.€5:13
JEA INFORMATION REQUIRED ON ALL PERMITS: (d°AMPS 7Ck,OLTS / PHASE
❑ NEW SERVICE: ❑ Overhead ❑Underground ❑Underground up Pole
❑Residential (Main)Service:
❑0-100 amps o101-150amps o151-200amps o amps #of Meters
❑Commercial(Main)Service:
❑0-100 amps o101-150amps n151-200amps ❑ amps ❑CT Service amps
Conductor Type Size
❑Multi-Family(Main)Service:
❑0-100 amps o101-150amps u151-200amps ❑ amps #of Unit Meters
❑ TEMPORARY POLE: amps
❑ SERVICE UPGRADE: ❑ amps ❑CT Service amps
❑ NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES, ETC.):
❑100 amps ❑150amps n200amps ❑ amps oCTService amps
❑ ADDITIONS, REMODELS, REPAIRS, BUILD-OUTS,ACCESSORY STRUCTURES, ETC:
Outlets/Switches: 0-30a m ps 31-100amps 101-200am ps
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 nSign ❑Smoke Detectors (Qty) ❑Transformers KVA ❑Motors HP
n FIRE ALARM SYSTEM (Requires 3 sets of plans):
Qty volts/amps
REPAIRS/MISCELLANEOUS:
LIReplace Burnt/Damaged Meter Can Safety Inspection uPanel Change uOH to UG
Updated 10/17/18
nOther:
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 e provisions of anther state or local law regulation construction or the performance of
construction. 4,,tAr _1 Roh4.SQC.kcji'tne �.-�•'3 Number: Com?O 7 a ' J -Z�
Electrical Company: , / 6C. ttl' .Office Phone: 90(f- ,j4 3/ Ii Fax:
Co.Address: Zi 1 C g,it(I b� GCity: C S State:,t9 Zip: 3 ly
License Holder: —11ld othState Certification/Registration#: F.0.0.0F.0.0.0i 31'7 2--
411Notarized Signature of License Holder / V
The foregoing instrument was acknowledged before me this ' day s �� I icLis___„„n thate of Florida,County of
gnature of Notary Pub' i ,
.•%tr.i;••, TONI GINDLESPERGER _
''. . MY COMMISSION A FF 924951 I
l'A 1'4EXPIRES:October6,
•A:� N:' bondedThruNotary 2019 ] Personally Known OR[ ] Produced Identification
''^' iF: `' pe of Identification: