584 Seaspray Ave ERES19-0172 Meter Can _]
YS"�'lr/f3 ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
r$ �
CITY OF ATLANTIC BEACH ERES19-0172
ISSUED: 6/24/2019
800 SEMINOLE ROAD EXPIRES: 12/21/2019
ATLANTIC BEACH. FL 32233
-11
MUST CALL INSPECTION • i , FOR i
ALL i 'K MUST CONFORM TO THE CURRENT 6TH EDITIOIN,�(2017) OF i ' + BUILDING
CODE, NEC, IPMC, AND OF + NTIC BEACRCODE 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-
584 SEASPRAY AVE ELECTRICAL RESIDENTIAL REPLACE METER CAN $500.00
TYPE OF
ZONING: :D •
CONSTRUCTIOROUP:
170703 0428 SEASPRAY
COMPANY: ADDRESS: CITY: STATE. i, zip:
AMERICAN ELECTRICAL 5065 ST AUG USTINE RD #13 JACKSONVILLE FL 32207
CONTRACTING, INC.
• ADDRESS: CITY: STATE: ZIP:
SULLIVAN THOMAS J 584 SEASPRAY AVE ATLANTIC BEACH FL 32233-4165
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.
'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 4S5-0000-322-1000 0 $55.00
STATE DBPR SURCHARGE 4SS-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $94.00
Issued Date: 6/24/2019 1 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
CSICi - ( 7z
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:
JOB ADDRESS:'584 Sea Spray Ave PROJECT VALUE$4 500.00
IEA INFORMATION REQUIRED ON ALL PERMITS:200 AMPS:240 VOLTS 1 PHASE
❑NEW SERVICE: 13 Overhead ❑Underground ❑Underground up Pole
r3Residential(Main)Service:
❑0-100 amps ®101-150amps [3151-200amps ®-amps #of Meters
OCommercial(Main)Service:
❑0-100 amps [3101-150amps 13151-200amps amps ❑CT Service amps
Conductor Type Size
®Multi-Family(Main)Service:
❑0-100 amps [3101-150amps [3151-200amps I3 amps #of Unit Meters
❑TEMPORARY POLE: amps
SERVICE UPGRADE:[]_amps ❑CT Service amps
❑ NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES, ETC.):
[]100 amps ❑150amps ❑200amps ❑ amps OCTService 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
❑✓ REPAIRS/MISCELLANEOUS:
OReplace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change []OH to UG
❑)cher: Updated 20/17/18
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:TOM Sullivan Phone Number:K?R3)7164248
Electrical Company: Amedcan Elecrical tr37arroOffiPhon : �o •• r'�,`::
Fax:
Co.Address:;5065 St Augustine Rd. ' '
city; - --"
V State: F�„1 Zip:X2207 ..:.
License Holder: Earl W. Frick State Certificatlon/Registration#:KCC13007311
Notarized Signature of license Holder'
The foregoing instrument was acknowledged before me this day f 20 in th State of Florida,County of
Signature of Notary Public
Notary Public State of Florida ///���)))
Angel N Brooks Personally Known OR[ ]Produced Identification
My commimon 0G 21711814 V e of Identification:
VIVExplree 70/1712022