594 Cruiser Ln ERES19-0140 Fixtures for Glass Room 0;—J !
ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH ERES19-0140
ISSUED: 5/22/2019
80NTIC BE CH.OLE ROAD EXPIRES: 11/18/2019
ATLANTIC BEACH. FL 32233
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL
• • l( MYST C1NF4R7A Tt THE CVRREUT fTH E1ITI1Wt2117) •F TWE FL4:!?-ID"—IjtmvG
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 aswater management districts,state agencies,orfederal agencies.
• . . . r • r • OF WORK:
594 CRUISER LN ELECTRICAL RESIDENTIAL fixtures for glass room $500.00
TYPE OF REALESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
1707030330 SEASPRAY
ADDRESS:
R & R ELECTRIC COMPANY P O BOX 60665 JACKSONVILLE FL 32236
• ADDRESS:
KINSEY JERRY A 594 CRUISER LN ATLANTIC BEACH FL 32233-4115
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-
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
ELEC LIGHTING OUTLETS,INCLUDING FIXTURES 455-0000-323-1000 2 $1.20
ELEC SWITCH AND RECEPTACLE OUTLETS 455-0000-3221000 0 $3'00
ELECTRICAL BASE FEE 455 LOW 322-1000 0 $55.00
STATE OBPR SURCHARGE 455-0000-208-0700 0 $2'00
STATE DCA SURCHARGE 455-MM-208-0600 0 $300
TOTAL:$63.20
Issued Date: 5/22/2019 1 of 2
"ALL
ION
Electrical Permit Application HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:
JOB ADDRESS: 594ionuiser Lane PROJECT VALUE$E 5oi
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JEA INFORMATION REQUIRED ON ALL PERMITS: 200 AMPS 130 VOLTS 1 PHASE
[3 NEW SERVICE: E3 overhead []Underground [3Undergroundup Pole
CResidential(Main)Service:
D0-100amps IM01-150amps 0151-200amps 171 amps #of Meters_
pCcmmercial(Main)Service:
❑0-100 amps 0101-150amps 0151-200amps 11 amps ❑CT Service_amps
Conductor Type Size
EIMulti-Family(Main)Service:
00-100 amps 0101-150amps E3151-200amps ❑_amps #of Unit Meters
❑TEMPORARY POLE:_amps
❑SERVICE UPGRADE:❑_amps OCT Service amps
❑ NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.):
❑100amps ❑150amps ❑200amps ❑_amps ❑CTServiceamps
❑ ADDITIONS, REMODELS, REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC:
Outlets/Switches: s 0-30amps 31-100amps 101-200amps
Appliances: _0-30amps 31-100amps _101-200amps
A/C Circuits: 0.60amps 61-100amps
Heat Circuits: If circuits @kw
Number of Lighting Outlets, Including Fixtures: 3
OTHER ELECTRICAL PROJECTS:
❑Swimming Pool[ Sign ❑Smoke Detectors (Qty) (]Transformers 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 upomed:o1n/ze
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. Al 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: Lois Kinsey Phone Number: (904)241-1524
Electrical Company: RW Electric of Nom Mnda Office Phone: 0,M)>e46555 Fax:iso-)—ur
Co.Address: P0131sx60665 City: Jacksonville State: FL Zip: 33236
License"older: Robert A SalleRe Jr - State Certification/Registration#: E60001316
NotarizedSignature afticenseHolder 4
The foregoing instrument was acknowledged before me this&day of 2 �q in the State of Florida,County of�U J
KAREN G HENDERSON 5ign it re
of Notary Public n11 m ��`/�II/hd Lx�.B-ry
My COMMISSION 0 GGOWZet personally Known OR[ ]]Produced Identification
'r¢
EXPIRES March 07.2021 Type of Identification:
�19
Cash Register Receipt Receipt Numbe
City of Atlantic Beach R9116
DESCRIPTION ACCOUNT •
PermitTRAK $63.20
ERE519-0140 Address: 594 CRUISER LN APN: 170703 0330 $63.20
ELECTRICAL $59.20
ELECTRICAL BASE FEE 455-0000-322-1000 0 $55.00
ELEC SWITCH AND RECEPTACLE OUTLETS 455-0000-322-1000 0 $3.00
ELEC LIGHTING OUTLETS,INCLUDING 455-0000-322-1000 2 $1.20
FIXTURES
STATE SURCHARGES $4.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
ITOTAL FEES PAID BY RECEIPT: R9116 $63.20
Date Paid: Wednesday, May 22, 2019
Paid By: R& R ELECTRIC COMPANY
Cashier:CB
Pay Method:CREDIT CARD 1 4
Printed:Wednesday,May 22,20198:26 AM 1 of 1 �I