1850 Tierra Verde Dr ERES19-0209 Elec for Kitchen ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH ERES19-0209
800 SEMINOLE ROAD ISSUED: 7/18/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 1/14/2020
MUST CALL INSPECTION • • • 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL • 'K MUST CONFORM TO 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:
1850 TIERRA VERDE DR ELECTRICAL RESIDENTIAL ELECTRIC FOR KITCHEN $1400.00
REMODEL
TYPE OF
ZONING: :D •
• iGROUP:
169542 5062 SELVA TIERRA
COMPANY: ADDRESS:
INFINITY ELECTRICAL 281 HORSETAIL AVENUE MIDDLEBURG FL 32068
CONTRACTNG
• ADDRESS: CITY: STATE: ZIP:
CHRISMAN LIVING TRUST 4100 QUEEN EMMAS DR 4100#31 Princeville HI 96722
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 C,ONDI-TIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
ELEC LIGHTING OUTLETS,INCLUDING FIXTURES 455-0000-322-1000 5 $3.00
ELECTRICAL BASE FEE 4SS-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: $62.00
Issued Date: 7/18/2019 1 of 2
ALL
* ON
WyElectrical Permit Application HIGHLIGHTEDIN
Sfl City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:
JOB ADDRESS: 12-50 T/-e l'rc�,. �1 l�c� PROJECT VALUE$ �yU�UV
JEA INFORMATION REQUIRED ON ALL PERMITS: AMPS V VOLTS -1 PHASE
❑ NEW SERVICE: ❑ Overhead ❑Underground ❑Underground up Pole
❑Residential (Main)Service:
110-100 amps o101-150amps o151-200amps ❑ amps #of Meters
❑Commercial (Main)Service:
❑0-100 amps o101-150amps o151-200amps ❑ amps ❑CT Service amps
Conductor Type Size
❑Multi-Family(Main) Service:
❑0-100 amps o101-150amps o151-200amps ❑ amps #of Unit Meters
❑ 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: S 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
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:
❑Replace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change ❑OH to UG _
Ather: 2eu,e,-9,r_ w i e,tig iN I�� �C�N 47r /Z- /_)&&0 )__ca'/ pal 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: r Phone Number:
Electrical Company:�`i�-6� of r+Gc�( 69o,�-`/�°`COfticeyPhone: (/U�—S'3S-0= Fax:
Co.Address: 'e l Citv: _'- T,ujLt State: Zip: -ZL2 �Y
License Holder: v� JTC ^�� to Certification/Re ' ation#: cp_t 3c?/.S-34�Z
Notarized Signature of License Holder
The foregoing instrument was acknowledged before me this d y of to of Florida,County of Q�I
Signature of Notary Public
4A MNIGINDLESPERGER
:- MY COMMISSION#FF 925951
!V EXPIRES:October 6,2019 1 ] Personally Known OR[ ] Produced Identification p
UF°`' Bonded Thru Notary Public Underwrite, Type of Identification: S 3 — S U� 7 — z — 0
f
f Cash
City of
Beach • • • •
DESCRIPTION • QTY PAID
PermitTRAK $62.00
ERES19-0209 Address: 1850 TIERRA VERDE DR APN: 169542 5062 $62.00
ELECTRICAL $58.00
ELECTRICAL BASE FEE 455-0000-322-1000 0 $55.00
ELEC LIGHTING OUTLETS,INCLUDING 455-0000-322-1000 5 $3.00
FIXTURES
STATE SURCHARGES $4.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
• R9616 $62.00
Date Paid: Thursday,July 18, 2019
Paid By: INFINITY ELECTRICAL CONTRACTNG
Cashier: CT
Pay Method: CREDIT CARD 080988
Printed:Thursday,July 18, 2019 3:35 PM 1 of 1i