31 5th St ERES19-0218 Elec for Lift ''`''`�� ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH ERES19-0218
800 SEMINOLE ROAD ISSUED: 7/25/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 1/21/2020
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORMTO THE CURRENT • 1 OF •
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:
31 5TH ST ELECTRICAL RESIDENTIAL ELECTRIC FOR LIFT $300.00
TYPE OF
GROUP:
• •
170153 0000 ATLANTIC BEACH
COMPANY: DDR
CRAWFORD ELECTRIC 2301 Marsh Point Road Neptune Beach FL �32�}2!666
• ADDRESS: ®
MCCALL ROSE MOODY LIFE 31 5TH ST ATLANTIC BEACH FL 32233-5307
ESTATE
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.
CONDITIONSLIST OF
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 SWITCH AND RECEPTACLE OUTLETS 455-0000-322-1000 0 $0.60
ELECTRICAL BASE FEE 455-0000-322-1000 0 $55.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $59.60
Issued Date:7/25/2019 1 of 2
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233 n C
CPh(904) 247-5826 Fax (904)247-5845 2�
OB ADDRESS: .
,.:)� -T--�-T1�,_ I. PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITSAMPS 'L U VOLTS PHASE
VALUE OF WORK$ 3D0,'0
NEW SERVICE ❑ Overhead ❑ Underground ❑T Underground up Pole
_Residential (Main) Service
--0-100 amps 101-150amps 151-200amps amps #of Meters
Commercial(Main)Service
0-100 amps 101-150amps 151-200amps amps -LCT Service an, •
Conductor Type Size
Multi-Family(Main)Service
=:0-100 amps =101-150amps ❑151-200amps a amps #of Unit Meters
Temporary Pole =- amps ----
SERVICE UPGRADE amps 7 CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
100 amps '-7 150amps 200amps --_amps a CT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: :N _0-30amps 31-100amps 101-200amps
Appliances: 0-30amps 31-100amps 101-200amps
A/C Circuits: 0-60amps 61-1100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
Swimming Pool Sign '--,'Smoke Detectors_Qty F-'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 ❑Safety Inspection ']Panel Change ❑OH to UG
'
ther:_ rel G ���Y l/► I V//1,1 v�
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.
Property Owners Name
Phone Number q&/- ' ,I a`I,5_
Electrical Companny1 face Phone �Fa ��b37
Co. Address: 2 I Ak& tfte f City StateU, Zip
License Holder(Print): Oh State Certification/Registration#
farized Signature of License Holder
o�+'"="'sus: �� WALKER uvcoM�tissioN�cc ooetit ay oSworn' d subscribed befor me this df l /n�
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a OMs:�,�2�.zoic
Aa.Uo Signature of Notary Publ' (�