1003 Jasmine St ERES19-0148 Add Outlets/Appl s1' ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH ERES19-0148
ISSUED: 5/22/2019
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233MUST CALL INSPECTION PHONE LINE (904) 247-5814 EXPIRES: 11/18/2019
Y 4 PIM FOR NEXT DAY INSPECTION.
1 CONFORM 1 EDITION 1 OF • ' 1A BUILDING
ALL
CODE,
1 1 CITY OF ATLANTIC BEACH CODEORDINANCES .
ALL CONDITIONS OF 1
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.
150 amps/240 volts/first
1003 JASMINE ST ELECTRICAL RESIDENTIAL phase - add outlets, $450.00
appliance
BUILDINGTYPE OF REALESTATE : r
CONSTRUCTION: NUMBER: ZONING: GROUP:
170991 0010 ATLANTIC BEACH SEC H
GREEN BUILT
CONSTRUCTION & 3653 REGENT BOULEVARD, 4306 JACKSONVILLE FL 32224
DEVELOPMENT
OWNER: ADDRESS:
WERNER FRANK 1003 JASMINE ST ATLANTIC BEACH FL 32233-1816
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 . r
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
ass-00Dc) 2L1D0D D 1800
ELEC APPLIANCES FIXED 00.STATIONERY $1800
EIEC SWITCH AND RECEPTACLE OUTLETS 455-ODOOd22300D 0
$55.00
ELECTRICAL BASE FEE
455-0OOOd22-10pD 0
Issued Date:5/22/2019
of 2
ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH ERES19-0148
800 SEMINOLE ROAD ISSUED:5/22/2019
,.r ATLANTIC BEACH.FL 32233 EXPIRES: 11/18/2019
STATE OBRR SURCHARGE CSB-0000.208-0700 0 52M
STATE 0U SURCHARGE ARS-0000.2080800 0 52.00
TOTAL:$79.00
Issued Date:5/22/2019 2 of 2
**ALL INFORMATION o-
® Electrical Permit Application HIGHLIGHTED IN
city of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 EQ/GSkq ,p li
Phone: (904) 247-5826 Email: Building-Dept@coaLus PERMIT#: Pes 6 0/39
JOBADDRESS: /D03 -$Ps m.+`d $T AT"L-^rx7-L PROJECT VALUE$ Fyfo, 00
JEA INFORMATION REQUIRED ON ALL PERMITS: /sa AMPS?y0 VOLTS I PHASE
❑NEW SERVICE: [3 overhead 13Underground 13Underground up Pole
presidential(Main)Service:
[30-300amps 13101-150amps 13151-200amps 1_amps #of Meters_
t7Commercial(Main)Service:
DO-100amps 13101-150amps 0151-200amps E3 _amps E3CT Service amps
Conductor Type Size
OMultl-Family(Main)Service:
❑1-100 amps 0101-150amps []151-200amps lamps #of Unit Meters
❑TEMPORARY POLE:_amps
❑SERVICE UPGRADE:❑_amps ❑Cf Service amps
❑NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.):
)]100amps 0150amps 0200amps 0_amps OCTService_amps
❑ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES, ETC:
Outlets/Switches: 3a 0-30amps _31-100amps _101-200amps
Appliances: 1 0-30amps __31-100amps _101-200amps
A/C Circuits: 0-60amps _61-1OOamps
Heat Circuits: _# circuits @_kw
Number of Lighting Outlets, Including Fixtures:
❑OTHER ELECTRICAL PROJECTS:
05wimming Pool[]Sign 05moke Detectors_(Qty) ❑fransformers KVA []Motors His
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 Updated 10/17/18
0)ther:
Permit becomes void if work does not commence within a six month period or work is suspended or abandoned fth Ihereby certify that I h
ave
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. f#.+4�K W�n.NCN Phone Number: 14f?- Yy.f 501,)"
Name:Owner Nam
Electrical Company: C T«4 pe`1 ('ov;rr--cL.^ Office Phone: q o V- b J S-6 6F 1 Fax:
Co.Address: 4 pS 7 IZ,ca. T 1,31 V o city: 11% state:g& zip: 7-1-Z Y
LicenseHolder:
as,6e&,T D 1,v i l State Certification/Registration#: CC — 1300 69 14
Notarized signature of License Holder
The foregoing instrument was acknowledged before me this day of 0 in the State of Florida,County of V'1N4)
ic
JENNIFER JOHNSTON nature Of Notary Public \ `f
COMMISSIONNGG042BBc XPIRES.OcbEer 2T,N20Personally Known OR(pTi'C du�ced Ipa pe of Identification:rNU NONry me uMernnlen