1611 Beach Ave ERES19-0188 A/C ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
ERES19-0188
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD ISSUED: 6/20/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 12/17/2019
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
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 as water management districts, state agencies, or federal agencies.
JOB ADDRESS: PERMIT TYPE-:---- DESCRIPTION: VALUE OF WORK:
1611 BEACH AVE ELECTRICAL RESIDENTIAL ELECTRIC -A/C CIRCUIT& $350.00
MINI SPLIT
TYPE OF REALESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: —NUMBER: GROUP:
NORTH ATLANTIC BCH
1696470000 UNIT 1
COMPANY: ADDRESS: CITY: STATE: ZIP:
DESTINY ELECTRIC 2850 CIRCLE RIDGE RD ORANGE PARK FL 32065
OWNER: ADDRE CITY: STAT zi
WILKINSON HENRY 1611 BEACH AVE ATLANTIC BEACH FL 32233
BROOKS
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 ORAN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
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 AIR CONDITIONING CIRCUITS 4SS-0000-322-1000 G $5.00
ELECTRICAL BASE FEE 4SS-0000-322-1000 0 $55.00
STATE DBPR SURCHARGE 4S5-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 4SS-0000-208-0600 0 $2.00
Issued Date: 6/20/2019 1 of 2
HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 C- C�
Phone: (904) 247-5826 Email: Building-Dept@cclab.us PERMIT#-
JOB ADDRESS: .144j1?& 3�Z�- iOJECT VALUE $ -T
JEA INFORMATION REQUIRED ON ALL PERMITS: AMPS VOLTS PHASE
El NEW SERVICE: 11 Overhead OUnderground OUnderground up Pole
E311esidential (Main)Service:
00-100 amps 0101-150amps [1151-200amps Q—amps #of Meters
OCommercial(Main)Service:
[10-100 amps [1101-150amps 11151-200amps amps []CT Service_amps
Conductor Type Size
ElMulti-FarnillY(Main)Service:
[ID-100 amps E1101-150amps [3151-200amps []_amps #of Unit Meters
F]TEMPORARY POLE: amps
SERVICE UPGRADE: 0 amps OCT Service amps
NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.):
[]100 amps E]150amps []200amps [I amps [3ET Service amps
ADDITIONS, REMODELS, REPAIRS, BUILD-OUTS,ACCESSORY STRUCTURES, ETC:
Outlets/Sw itches: 0-30amps 31-100amps 101-200amps
Appliances: 30amps 31-100amps 101-200amps
A/C Circuits: —��Zo--60amps 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS:
[]Swimming Pool E]Sign E]Smoke Detectors (Qty) OTransformers KVA []Motors HP
FIRE ALARM SYSTEM (Requires 3 sets of plans):
Qty volts/amps
REPAIRS/MISCELLANEOUS:
E]Replace BUrnt/Damaged Meter Can EI.Safety Inspection lChange []OH to UG
her:—�I]ljre, fDr � t)S4-ajk vvlo ) ko ,7,a-7 t/Cj1+�pdted10/17/18
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. '5kv"A e- T)- �c 5�oLi - 70 ?.-q ,7
Owner Name: Phone Number:
T)f�h'
Electrical Company: t -i�4 or ji� OfficePhone: Fax:
Co.Address: CI'L61C' eiC�e- D,- City: (Dro-,15e /q,'t-YC- State:_F(- zip: -37-0(o5-
License Holder: !24,7,f 4e�fX State Certification/Registrat ion#: 2-2- A,
Notarized Signature of License Holder
The foregoing instrument was acknowledged before me this day of_JUI�-- �20L in the State of Florida,County of Cki
KYLE HATLEE Signature of Notary Public
MY COMMISSION#GG072966
EXPIRES:FEB 14,2021 Personally Known OR' Produced Identification
r�V Bonded through 1 st State Insurance
Receipt Number
Cash Register Receipt
City of Atlantic Beach R9362
DESCRIPTION ACCOUNT QTY PAID —
PermitTRAK $64.00
ERES19-0188 Address: 1611 BEACH AVE APN: 169647 0000 $64.00
ELECTRICAL $60.00
ELECTRICAL BASE FEE 455-0000-322-1000 0 $55.00
ELEC AIR CONDITIONING CIRCUITS 455-0000-322-1000 0 $5.00
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: R9362 $64.00
Date Paid: Thursday,June 20, 2019
Paid By: DESTINY ELECTRIC
Cashier: CB
Pay Method: CREDIT CARD 7
Printed:Thursday,June 20,2019 1:47 PM 1 of 1