582 Aquatic Drive ERES19-0126 Outlets ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH ERES19-0126
ISSUED:4/29/2019
800 SEMINOLE ROAD EXPIRES: 10/2612019
ATLANTIC BEACH. FIL 32233,,
ALL WORK MUST CONFORM IU I Mr II &L1W5y-0TffA='
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
c
that may be found in the public records of this county,and there may be additional permits required from other
Inces.
F ces,or age
governmental entities such as water management districts,state agencies,oi ed ral
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
200 amps/240 volts/first
582 AQUATIC DR ELECTRICAL RESIDENTIAL phase -outlets for screened $1250.00
room
TYPE OF REALESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP: -
1718185194 AQUATIC GARDENS
COMPANY: ADDRESS: CITY: STATE: ZIP:
EMPIRE ELECTRIC INC 5810 Macy Avenue JACKSONVILLE FL 32211
OWNER: ADDRESS: CITY: ' STATE: ZIP:
HARTMAN GARY E 582 AQUATIC DR 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 CONDITIONS
Roll off container company must be on City approved list. Container cannot be placed on City right-of-way.
FEES
DESCRIPTION ALLUUN I
ELEC LIGHTING OUTLETS,INCLUDING FIXTURES 455 0000-322 1000 2 $120
ELEC SWITCH AND RECEPTACLE OUTLETS 455 0000,322-1000 a $2,40
ELECTRICAL BASE FEE 455 OM-322 1000 0 S5S.D0
STATE BEER SURCHARGE 455-0000 208 07W 0 $2,00
STATE OCA SURCH
ORE 455 0000 208 06W a
Issued Date:4/29/2019 1oI`2
ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH ERES19-0126
ISSUED:4/29/2019
800 SEMINOLE ROAD EXPIRES: 10/26/2019
ATLANTIC BEACH. FL 32233 F--7:::�TOTAL $62,60 I
i,sued Date:4/29/2019 2 of 2
ja Cash Register Receipt Receipt Number
City of Atlantic Beach R8881
DESCRIPTION ACCOUNT CITY PAID
PermitTRAK $62.60
ERES19-0126 Address; 582 AQUATIC DR APN: 171818 5194 $62.60
ELECTRICAL $58.60
ELECTRICAL BASE FEE -2 0 $5S.00
10222 $
ELEC SWITCH AND RECEPTACLE OUTLETS :5 111 31�1�jO2612 2 $2.40
ELEC LIGHTING OUTLETS,INCLUDING
FJXTLRES 455 0000-322-1000 2 $1�20
STATE SURCHARGES $4 00
2� 2
STATE DBPR SURCHARGE 455-0000-208-0700
—STATE DCA SURCHARGE 455-0000-208-OWO 0 1 $2.00
TOTAL FEES PAID BY RECEIPT: R8881 $62.60 1
Date Paid: Monday,April 29, 2019
Paid By: EMPIRE ELECTRIC INC
Cashier:CT
Pay Method: CREDIT CARD 050358
Printed:Monday,April 29,2019 12:07 PM I Of 1
"ALLINFORNIATION
Electrical Permit Application
HIGHLIGHTED IN
City of Atlantic Beach Building Department !L GRAY IS REQUIRED.
800 Seminole Rd,Atlantic Beach, Fl.32233 cz– 1�& S( I – 0(a ii,
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMITS&-5& ff�- q
JOB ADDRESS:—5 P 1 &�Od Ed— 12rf IL' PROJECT VALUE$—JI25�00
JEA INFORMATION REQUIRED ON ALL PERMITS: 20—AMPS&&VOLTS / PHASE
NEW SERVICE: E3 Overhead ClUnderground [lUndergroundup Pole
c3ifesidential(Main)Service:
E30-100 amps 0101-150amps 13151-200amps rl amps #of Meters
ElCommencial(Main)Service:
[30-100amps 13101-150amps 13151-200amps 13 amps 13CT Service_amps
ConductarType Size
CIMulti-Family(Main)Service:
M100amPs 13101-150amps E1151-200amps 173 amps #of Unit Meters
OTEMPORARY POLE:
_amps
SERVICE UPGRADE:0_amps OCT Service_amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES, ETC.):
[3100amps 0150amps [3200amps Q_amps MService—amps
GrADDITIONS, REMOD�IS, REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES, ETC:
Outlets/Switches: 0-30amps 1-100amps _____101-200amp5
Appliances: 0-30amps 1-100amps 101-200amps
A/C Circuits: _____0-60amps 1-100amps
Heat Circuits; _# circuits @ kw
Number of Lighting Outlets, Includinj-H.—tures:
El OTHER ELECTRICAL PROJECTS:
awimming Pool 0SIgn OSmoke Detectors_(CIty) [Yransfornmers—I(VA E]Motors_HP
FIRE ALARM SYSTEM (Requires 3 sets of plans):
City—volts/amps
REPAIRS/MISCELLANEOUS:
[]Replace Burnt/Damaged Meter Can OSafety Inspection OPanel Change CIOH to UG
O)ther: UvdatedIO117118
OMmimmw�—
Permit becomes void if work does not commence wifthm�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: 6nj<� ge —Phone Number: 2-9
Electrical Company, EM r-- lAr�Office Phone: .%25--:7777 Fax-
Co.Address: 5,9/6 Me?-nia: glili
— City: State:Xl- ZIP:'
License Holcay: lqvo rd '5a State Certification/Registration#:
Notarized Signature afticense Holder
The foregoing instrument was acknowledged before me this ay 0 20 jin the State of Florida,County of buv,�ir
6%qjj._�o�
1,9,
;7,. J'ANIE5,.M SULLIVAN] Signature of Notary Public ZU
ULLV
say .'S'o F914214
my commISSION If FF974214
7 1 Personally Known OR r)Produced Alden:tf�ficaaF
"RE .r,7
'2 0
EXPIRES March 22.2120 on
�ype of Identification: