82 W 11th St ERES19-0160 panel change permit Ag&, ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH ERES19-0160
800 SEMINOLE ROAD ISSUED: 5/31/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 11/27/2019
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
CODEY 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:
82 W 11TH ST ELECTRICAL RESIDENTIAL 200 amps/240 volts/first $1400.00
phase - panel change
TYPE OF REALESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
1708110600 ATLANTIC BEACH SEC H
COMPANY: ADDRESS: CITY: STATE: ZIP:
AMERICAN ELECTRICAL 5065 STAUGUSTINE RD#13 JACKSONVILLE FL 32207
CONTRACTING, INC.
OWNER: ADDRESS: CITY: STATE: ZIP:
MANN L CHARLES 165 ARLINGTON RD N JACKSONVILLE FL 32211-7863
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
AT-FORNEY 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.
0
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
ELEC REPAIRS AND MISC 455-0000-322-1000 0 $35.00
ELECTRICAL BASE FEE 455-0000-322-1000 0 $55.00
STATE DBPR SURCHARGE 4S5-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL:$94.00
Issued Date: 5/31/2019 1 of 2
ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH ERES19-0160
800 SEMINOLE ROAD ISSUED: 5/31/2019
ATLANTIC BEACH, FL 32233 EXPIRES: 11/27/2019
Issued Date:5/31/2019 2 of 2
Electrical Permit Application "ALL INFORMATION
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@cciab.us PERMIT#: 6e-&,s ICI
In el
JOB ADDRESS: I)L UJID —PROJECT VALUE 4co
JEA INFORMATION REQUIRED ON ALL PERMITS:2j[)LAMPS_214QVOLTS Lj_PHASE
NEW SERVICE: 13 Overhead OUnderground [3Underground up Pole
Mesidential(Main)Service:
130-100 amps 0101-150amps 13151-200amps amps #of Meters
13Commercial(Main)Service:
130-100 amps [3101-150amps E3151 200amps 0—amp5 13CT Service amps
Conductor Type Size
MMulti-Family(Main)Service:
[3D-100 amps [3101-150amps [3151-200amps amps #of Unit Meters
TEMPORARY POLE: amps
ED SERVICE UPGRADE:O_amps OCT Service, amps
F-1 NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES, ETC.):
[3100amps [3150amps [3200amps [3 amps [3CT Service_amps
L1 ADDITIONS, REMODELS, REPAIRS, BUILD-OUTS,ACCESSORY STRUCTURES, ETC:
Outlets/Switches: 0-30amps 31-100amps 101-200amps
Appliances: 0-30amps 31-100amps 101-200amp
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
El OTHER ELECTRICAL PROJECTS:
[]Swimming Pool F—]Sign []Smoke Detectors (Qty) [3Transformers KVA DMotors HP
F-]FIRE ALARM SYSTEM (Requires 3 sets of plans):
Qty volts/amps
REPAIRS/MISCELLANEOUS:
[]Replace Burnt/Damaged Meter Can []Safety Inspection KpanelChange E]OH to UG Updated 10/17118
ather:
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 complied with whether
specified or not. The permit does ve authority to violate the provisions of any other state or local law regulation construction or the performance of
construction.
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Owner Name:,—Cebo� t� - 2.U--11
Electrical CornDanv:X)lv\kv
P.\er- Ift C Jci k Offirp hone Fax:
'71220-1
Co.Address: city: Statero Zip:
License Holder:'Eak)i, Wgrcicl State Certificat Registration M
c----
Notarized Signature of License Holder
The foregoing instrument was a k ledged before me this jAj—da f 20 in the State of Florida,County of
A/Via ,
Nowy Public State ol!Florida Signature of Notary Public Wil"
4ef AnO N Brooks — 'j
my com"sw 0 2eae 14 Personally Known OR Produced Identification
Expires iotiT12022
ON^^
gim] XPI of Identification:
7 Cash Register Receipt Receipt Number
City of Atlantic Beach R9192
DESCRIPTION ACCOUNT QTY PAID
1 PermitTRAK $94.00
ERES19-0160 Address: 82 W 11TH ST APN: 1708110600 $94.00
ELECTRICAL $90.00
ELECTRICAL BASE FEE 455-0000-322-1000 0 $55.00
ELEC REPAIRS AND MISC 455-0000-322-1000 0 $35.00
STATE SURCHARGES $4.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL FEES PAID BY RECEIPT: R9192 $94.00
Date Paid: Friday, May 31, 2019
Paid By: AMERICAN ELECTRICAL CONTRACTING, INC.
Cashier: CT
Pay Method: CREDIT CARD 815411
Printed: Friday, May 31,2019 10:05 AM 1 of 1