380 12th St ERES19-0131 New Service =ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
ERE519-0131
ATLANTIC BEACH ISSUED: 5/8/2019
SEMINOLE ROAD EXPIRES: 11/4/2019
TIC BEACH. FL 32233
r , • . • .
CODE,ALL WORK MUST CONFORM TO
AND CITY OF • • OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
F
ICE:In addition to the requirements of this permit,there may be additional restrictions applicable to this property
may be found in the public records of this county,and there may be additional permits required from other
ernmental entities such as water management districts,state agencies,or federal agencies.
300 amps/240 volts/first $35000.00
380 12TH ST ELECTRICAL RESIDENTIAL phase- new service
SUBDIVISION:
TYPE OF REALESTATE ZONING: BU GROUP:
CONSTRUCTION:
• 1719300000 SELVA MARINA UNIT 01
• . . r
T& M ELECTRIC INC 200 College DR ORANGE PARK FL 32065
PETER &AMY POLLAK 38012TH ST ATLANTIC BEACH FIL 32233-5514
=BEFORERECORDING
WNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF
NT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST
YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
RE RECORDING YOUR NOTICE OF COMMENCEMENT.
Roll off containercompany must be on City approved list. Container cannot be placed on City right-of-way.
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
ELEC NEW SINGLE FAMILY 455-0000-3321000
oB $sO.Gc
0 $S.BB
ELECTRICAL BASE FEE 455-0000-33&1000
0 $218
STATE OBPR SURCHARGE 455-0000-308-0)00
v $2,00
STATE OCA SURCHARGE 4550000-308-0600
TOTAL:$149.18
of t
Issued Date:5/8/2019
ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH ERES19-0131
ISSUED: 5/8/2019
800 SEMINOLE ROAD EXPIRES: 11/4/2019
ATLANTIC BEACH. FL 32233
Issued Date:5/8/2019 2 oft
Electrical Permit Application ALL INFORMATION
Application HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233
"o,j' � Phone: (904) 247-5826 Email: Build ing-Dept@coab.us PERMIT#; &�Sl�'DIS/
JOB ADDRESS: ,°>qo �2':`- S-� PROJECT VALUE$ ^.. ) –,UZZg 00
}},.�( JEA INFORMATION REQUIRED ON ALL PERMITS: 3CZAMPS 1�lt)' VOLTS L PHASE
I�f1EW SERVICE: OOverhead []Underground OUnderground up Pole
'' vv presidential (Main)Service:
C30-100amps 0101-150amps [)151-200amps 56D amps It of Meters_
Murnmercial(Main)Service:
®0-100amps O101-150amps OS51-200amps q_amps OCT Service amps
Conductor Type Size
OMulti-Family(Main)Service:
O]-100 amps ❑101-150amp ^^ 0351-200amps E3_amps #of Unit Meters
❑TEMPORARY POLE: amps1 �WTC� rk.1 ao)
SERVICE UPGRADE:❑_am``ps []CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES, ETC.):
OSOOamps 13150amps ❑200amps E3 amps OCTService_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 Detectom (Qty) ❑rransformers KVA []Motors HP
❑FIRE ALARM SYSTEM(Requires 3 sets of plans):
qty volts/amps
❑ REPAIRS/MISCELLANEOUS:
❑Replace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change ❑OH to UG
updoeedda/v/tit
lather:
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 compiled 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: J A LONG — (O O liar t Phone Number: (1101)261-3075
Electrical Company: T6M ELECTRIC OF CLA CO.,LLc. f ice Phone: (a11e2RL3r] Fax
Co.Address: 200 COLLEGE Ori. City: ORANGE PMN State: FL Zip: 32055
Ucense Holder ATALIN State Certification/Registration#: E120001152
NotaAzed Signpture 011—se Holder
The t as acknowl dg be o guy da Y 20111 in the State of Florida,County of(`1N`f
:My TINA L. BURT nature of Notary Pub ll r
State of Florida-Notary Pu im
Commission GG 20669 Personally Known OR( I Produced Identification
C13910a lun Expires
May 01. 2022 pe of Identification: