221 Pine St ERES19-0180 Replace Weather Head ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
J pl
CITY OF ATLANTIC BEACH ERES19-0180
800 SEMINOLE ROAD ISSUED: 6/14/2019
" t19r ATLANTIC BEACH. FL 32233 EXPIRES: 12/11/2019
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORMTO THE CURRENT 6TH EDITION1 OF • '
CODE, ' OF BEACH CODEOF 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:
221 PINE ST ELECTRICAL RESIDENTIAL REPLACE WHEATHER HEAD $250.00
TYPE OF
• • GROUP:
170564 0000 SALTAIR SEC 03
COMPANY: ADDRESS:
BARKOSKIE ELECTRICAL 953 Shetter Ave JACKSONVILLE FL 32250
SERVICE BEACH
• ADDRESS:
SPRAGUE JUDITH M 221 PINE ST JACKSONVILLE 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
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
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 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $94.00
Issued Date:6/14/2019 1 of 2
Electrical Permit Application "ALL INFORMATION
HIGHLIGHTED IN
n
City of Atlantic Beach Building Department GRAY IS REQUIRED.
a_- 800 Seminole Rd, Atlantic Beach, FL 32233
G,P- i C� _ ( Q
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT fl: _/ C U
JOB ADDRESS: Z 21 771rJE S�—t , PROJECT VALUE$ ZSO
JEA INFORMATION REQUIRED ON ALL PERMITS: 400 AMPS Z#O VOLTS_�PHASE
❑ NEW SERVICE: ❑Overhead ❑Underground []Underground up Pole
C311esidential (Main)Service:
❑0-100 amps 0101-150amps [1151-200amps ❑ amps #of Meters
❑Commercial(Main)Service:
❑0-100 amps E1101-150amps 13151-200amps ❑ amps []CT Service amps
Conductor Type Size
❑Multi-Family(Main) Service:
00-100 amps 0101-150amps 171151-200amps [:]_amps #of Unit Meters
❑TEMPORARY POLE: amps
SERVICE UPGRADE: ❑ amps ❑CT Service amps
❑ NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.):
E]100amps ❑150amps ❑200amps ❑ amps ❑CT Service 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 Detectors (Qty) ❑Transformers KVA ❑Motors HP
❑ FIRE ALARM SYSTEM (Requires 3 sets of plans):
Qty volts/amps
0EPAIRS/MISCELLANEOUS:
[]Replace Burnt/Damaged Meter Can []Safety Inspection []PanelChange ❑OH to UG
Ei�Yfher:_"FC—PL.A�C-E Updated 10/17/18
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 not give authority to violate the provisions of any other state or local law regulation construction or the performance of
construction.
Owner Name: JUDY S?i?-A4(,AC Phone Number: ZO)' 3Z 3— 6, 74,45
Electrical Company.>/�CRKOSK►IG �e LTR�G Office Phone: Z44, -4-73( Fax: �Bcf7
Co.Address: ��?J '50E-T" —yt- A-/C. city: _—LfY).4/3L9 State: ti, zip: gnsz
M G3 /414l�� G
License Holder: State Certification/Registration ligclo2 3 16
Notarized Signature of License Holder V �.a-µ-�-o
The foregoing instrument was acknowledged before me this day of u L 20_& in the State of Florida,County of Dmi
Margaret A.May
ConllnlssW#GG1 910 Signature of Notary Public
� Expires: July 24, 2020personally Known OR( ] Produced Ide ication
',? '�,d��;. Bonded thru Aaron Notary Type of Identification: