2139 Seminole Rd. ERES19-0109 Pool Electric 41E...,I,A'f,, ELECTRICAL RESIDENTIAL PERMITPERMIT NUMBER
rVit; CITY OF ATLANTIC BEACH ERES19-0109
800 SEMINOLE ROAD
ISSUED: 4/8/2019
Ol;> ve ATLANTIC BEACH. FL 32233 EXPIRES: 10/5/2019
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:
2139 SEMINOLE RD ELECTRICAL RESIDENTIAL ELECTRIC FOR POOL $2000.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
169515 0500 SECTION LAND
COMPANY: ADDRESS: CITY: STATE: ZIP:
MOORE ELECTRICAL 10526 CRAIG INDUSTRIAL DRIVE JACKSONVILLE FL 32225
CONTRACTORS, INC.
OWNER: ADDRESS: CITY: STATE: ZIP:
Camille Adams 2139 SEMINOLE RD ATLANTIC BEACH FL 32233-5921
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
ELEC SWIMMING POOLS 455-0000-322-1000 0 $40.00
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
TOTAL: $99.00
Issued Date:4/8/2019 1012
r=\,,I' ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
: ' ERES19-0109
s, CITY OF ATLANTIC BEACH
'� ISSUED: 4/8/2019
\ it
, 800 SEMINOLE ROAD
\` `� ATLANTIC BEACH. FL 32233 EXPIRES: 10/5/2019
Issued Date:4/8/2019 2 of 2
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
Ph(904) 247-5826 Fax (904) 247-5845 C RES(Qj -D I D 4
TOB ADDRESS: / 3 9 £.n7 ;A..D h levan PERMIT# Poo ii9•ogle*
LEA INFORMATION REQUIRED ON ALL PERMITS otp-O AMPS VOLTS PHASE
VALUE OF WORKS aDO O
NEW SERVICE Overhead Underground I Underground up Pole
:Residential (Main) Service
00-100 amps ❑101-150amps ❑151-200amps ❑ amps # of Meters
❑Commercial(Main) Service
00-100 amps 0101-150amps 0151-200amps ❑ amps CCT Service amps
Conductor Type Size
❑Multi-Family(Main) Service
❑0-100 amps ❑101-150amps ❑151-200amps ❑ amps # of Unit Meters
:Temporary Pole ❑ amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps ❑150amps 0200amps ❑ amps CCT Service amps
UDDTTIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-30amps 31-100amps 101-200amps
Appliances: 0-30amps 31-100amps 101-200amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
DTFIER ELECTRICAL PROJECTS
XSwimmingPool ❑ Sign ❑Smoke Detectors Qty ❑Transformers KVA ❑Motors hp
EIRE ALARM SYSTEM (Requires 3 sets of plans&Fire Alarm Checklist)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
❑Replace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change ❑OH to UG
❑Other:
?ermit 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
•ead 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
;onstruction.
?roperty Owners Name //o/7"/_5',L /� Phone Number j:26, - 21.0-/c)3 8
Electrical Company neortf t7CC/ +
%C / (."o7L y:
.vC._ Office Phon80(-4i15-4.52.07 Faxiler-aef-ms's?
M. Address: Po deg 3Svs7y City f 6')( State/ / Zip32.Z+ 5
License Holder (Print): demi,vy 3 Cl- r State Certification/Registration#,�C'G /7yv
Votarized Signature of Licens Icier ,, �0 i
70N1GIND R •a th1S r, \ Z 20 L9
Irk\ MY COMMISSION#FF 924951 worn al/ ubscribed .efore
_*: 4' October 6,2019
EXPIRES ignature of Notary Public Q
Notary Pub14c Undenxraers
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