2265 Beachcomber Tr ERES19-0212 5 Fixtures ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
ERES19-0212
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD ISSUED: 7/17/2019
"='';»r ATLANTIC BEACH. FL 32233 EXPIRES: 1/13/2020
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL •RK MUST CONFORM T• THE CURRENT 6TH EDITION1 OF • ' ! + 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: PERMITTYPE: DESCRIPTION: VALUE OF WORK:1
2265 BEACHCOMBER TR ELECTRICAL RESIDENTIAL ELECTRIC RENO - 5 FIXTURES $340.00
TYPE OF + BUILDING
ZONING: :D •
• • GROUP:
169463 0158 OCEANWALK UNIT 01
COMPANY: ADDRESS:
RIVER CITY ELECTRIC INC 2825 HOLLYBAY RD ORANGE PARK FL 32073
• ADDRESS: STATE:
KENNELLY BRADLEY JR 2265 BEACHCOMBER TRL ATLANTIC BEACH FL 32233-4567
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 • ! i
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 LIGHTING OUTLETS,INCLUDING FIXTURES 455-0000-322-1000 5 $3.00
ELECTRICAL BASE FEE 45S-0000-322-1000 0 $55.00
STATE DBPR SURCHARGE 45S-0000-208-0700 0 $2.52
STATE DCA SURCHARGE 4SS-0000-208-0600 0 $2.00
WORK WITHOUT PERMIT 4S5-0000-322-1000 0 $110.00
TOTAL: $172.52!
Issued Date: 7/17/2019 1 of 2
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
Ph(904)247-5826 Fax (904) 247-5845 (`
JOB ADDRESS: `Z(o S Gl�/� C-v v—b��— PERMIT# l 9 - :2-I -7
JEA INFORMATION REQUIRED ON ALL PERMITS AMPS •Z�/y VOLTS 3=&_ / PHASE
VALUE OF WORK$ iia Eo
NEW SERVICE ❑ Overhead ❑ Underground ❑T Underground up Pole
❑Residential(Main)Service
00-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Meters
❑Commercial(Main)Service
00-100 amps ❑101-150amps ❑151-200amps ❑ amps OCT Service amps
Conductor Type Size
❑Multi-Family(Main)Service
00-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Unit Meters
❑Temporary Pole 0 amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps ❑150amps 0200amps ❑ amps OCT 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: 5-
OTHER ELECTRICAL PROJECTS
❑Swimming Pool ❑ Sign ❑Smoke Detectors_Qty ❑Transformers KVA ❑Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
❑Replace Burnt/Datnaged Meter Can ❑Safety Inspection ❑Panel Change DOH to UG
❑Other:
?ermit 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
•ead 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
pecified 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
:onstruction.
'roperty Owners Name Phone Number
;lectrical Company f-w<- 0, tic G.a Office Phone 7`l 1-OCR
Fax
:o.Address: 2`' Z t kk_1�011 a . City State Ft' Zip 31y7
,icense Holder(Print): State Certifi io egistration# EC- 5-08
Totarized Signature of License Holder
KITTY COOK efore me this t7?_day of_
• . Notary Public-State of Florida
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'= Commission#FF 920346 gnature of NotaryPu L
My Comm.Expires Jan 15,2020
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