55 S Forrestal Cir ERES19-0233 Irr Pump S' ,V ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
ERES19-0233
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD ISSUED: 8/5/2019
D=ij�r ATLANTIC BEACH, FL 32233 EXPIRES: 2/1/2020
Wr
MUST CALL INSPECTIONIF-H-6714-FUNE (904i-) 247-S814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORMTO THE CURRENT ! • 1 OF • ' ! + BUILDING
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, PLEASE READ CAREFULLY.
ENOTICE: In addition to the requirements of this permit,there may be additional restrictions applicable to this property
be found in the public records of this county, and there may be additional permits required from other
ental entities such as water management districts, state agencies, or federal agencies.
JOB ADDRESS: PERMIT TYPE: DESCRIPTION: VALUE OF WORK:
200 amps/240 volts/first
55 S FORRESTAL CIR ELECTRICAL RESIDENTIAL phase - 20 amp irrigation $450.00
pump
TYPE OF !
ZONING: : ! •
• • GROUP:
171737 0000 ATLANTIC BEACH VILLA
# 01
COMPANY: ADDRESS:
LIBERTY ELECTRICAL PO BOX 8743 JACKSONVILLE FL 32239
CONTRACTORS
• ADDRESS:
AMIG MICHAEL A 55 FORRESTAL CIR S ATLANTIC BEACH FL 32233
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 . ! •
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 MOTORS 455-0000-322-1000 2 $4.00
ELECTRICAL BASE FEE 455-0000-322-1000 0 $55.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
Issued Date: 8/5/2019 1 of 2
Srarl Electrical Permit Application "ALL INFORMATION
HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233
°;:`jPhone: (904) 247-5826 Email:r Building-De1-pt@coab.us PERMIT#: E-e�SI
!',' Ll � LJ � PROJECT VALUE$
JOB ADDRESS: �"� � -7 I��'� �-1
JEA INFORMATION REQUIRED ON ALL PERMITS:2, O AMPS' J VOLTS PHASE
❑ NEW SERVICE: ❑ Overhead ❑Underground ❑Underground up Pole
❑Residential (Main)Service:
❑0-100 amps ❑101-150amps 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 ❑101-150amps ❑151-200amps ❑ 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: 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:
A❑ eplace Bu nt/Dam ",ed Meter Can ❑Safety Inspection Pa I Ch e ❑OH to UG, � plo
ther: Q ,p r (�) f;6-'P UpdoI10/17/18
Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six mo s. 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-h 1
Y� Phone Number:
t
� �PSb
Electrical Company: Cjo��II f- (�`� Office Phone: 7by /�S l�b� Fa9lx: �y
Co.Address: ` 4- O City: (a�Js,&COI!l� State: r Zip:
• J' r 1
License Holder: Certification/Registration#:
Notarized Signature of License Holder
The foregoing instrument was acknowledged before this day of l,i S ,20 n the State of Florida,County of o
Y 6,; .•
JENNIFER Signature of Notary Public
= PAY COMMISSION#GG 042984
[ ] Personally Known OR[ �oduced Identification
EXPIRES:October 27,2020
BondedThruNotaryPublicundermiters Type of Identifications
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