1793 E Park Terr ERES19-0214 Elec Remodel ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
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_ CITY OF ATLANTIC BEACH ERES19-0214
v 800 SEMINOLE ROAD ISSUED: 7/18/2019
ATLANTIC-13 EACH. FL 32233 EXPIRES: 1/14/2020
INSPECTIONMUST CALL . • , , BY , PM FORDAY • !
ALL WORK ! • TO THE CURRENT 6TH EDITIONOF • ' iBUILDING
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF i 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:
1793 E PARK TER ELECTRICAL RESIDENTIAL 200 amps/240 volts/first $2500.00
phase - elec for remodel
TYPE OF
ZONING: :D •
• • GROUP:
172020 0418 SELVA MARINA UNIT 08
COMPANY: ADDRESS:
B & C ELECTRICAL INC 12447 PATRICK CT JACKSONVILLE FL 32225
OWNER: ADDRESS:
NIEMCZYK TODD R 225 SHERRY DR ATLANTIC BEACH FL 32233-5237
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.
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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 APPLIANCES FIXED OR STATIONERY 455-0000-322-1000 0 $10.00
ELEC LIGHTING OUTLETS,INCLUDING FIXTURES 455-0000-322-1000 15 $9.00
ELEC SWITCH AND RECEPTACLE OUTLETS 455-0000-322-1000 0 $6.00
ELECTRICAL BASE FEE 455-0000-322-1000 0 1 $55.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
Issued Date: 7/18/2019 1 of 2
''J'% ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
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CITY OF ATLANTIC BEACH ERES19-0214
8
ISSUED: 7/18/2019
00 SEMINOLE ROAD
ATLANTIC BEACH. FL 32233 EXPIRES: 1/14/2020
fTOTAL:$84.00
Issued Date: 7/18/2019 2 of 2
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach, FL 32233
Ph(90/4) 247-5826 Fax (904)247-5845
.TOB ADDRESS: � 79S �� `� 7er mre �� ( PERMIT# ( Q9 tS Oi.
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JEA INFORMATION REQUIRED ON ALL PERMITS AMPS VOLTS PHASE
VALUEOFWORK$
NEW SERVICE ❑ Overhead ❑ Underground ❑1 Underground up Pole
❑Residential(Main) Service
110-100 amps ❑101-150amps ❑151-200amps amps #of Meters
❑Commercial(Main) Service
❑0-100 amps ❑101-150amps ❑151-200amps amps [I CT Service amps
Conductor Type Size
❑Multi-Family(Main)Service
❑0-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Unit Meters
F1 Temporary Pole ❑ amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps ❑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 El Transformers KVA ❑Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
❑Replace Burnt/Damaged Meter Can El Safety Inspection ❑Panel Change El OH to UG
❑Other:
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. ,� l
Property Owners Name /" t eI77 e z t /4�f Phone Number
Electrical Company��'Z` �� � � 74-
;I rc� Zti Office Phone_(p2!�— 74/—r Fax
Co.Address: y R cf% City c-�C' r Stated Zip z 2 2J
License Holder(Print): til /'eeClIeSta:2? ation/Registration
Notarized Signature of License H
,;Y>u
JENNIFER JOHNSTON Before me this_�U da ofy U 20
MY coMMISSION#GG 042984 y �
EXPIRES:October 27,2020
eonded'!w Notary PubiicUnderwritets Signature of Notary Public