1957 Beach Ave ERES19-0230 Pool Elec ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH ERES19-0230
�r
800 SEMINOLE ROAD ISSUED:
ATLANTIC BEACH. FL 32233 EXPIRES:
MUST CALL INSPECTION ■ • • 1 i PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORMTO THE CURRENT 6TH EDITION1 OF • '
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF PERMIT APPLY, 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: j VALUE OF WORK:
1957 BEACH AVE ELECTRICAL RESIDENTIAL SWIMMING POOL ELECTRIC $985.00
TYPE OF •
ZONING: :D •
• • GROUP:
169696 0000 NORTH ATLANTIC BCH
UNIT 2
COMPANY: ADDRESS:
HAZOURI ELECTRIC, INC. P 0 BOX 56559 JACKSONVILLE FL 32241
• ADDRESS:
VAGHEFI 1UBEEN F 4401 SAN JOSE LN JACKSONVILLE Fl 32207
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 SWIMMING POOLS 455-0000-322-1000 0 $40.00
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: $99.00
Issued Date: 1 of 2
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach, FL 32233
Ph(904)247-5826 Fax (904) 247-5845 E_�: � _ bz 3�
JOB ADDRESS: 1 S &ec AY t PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS '70 6 AMPS Z `CV VOLTS / PHASE
icy ._
VAL UE OF WORK$
NEW SERVICE ❑ Overhead ❑ Underground ❑T Underground up Pole
❑Residential(Main) Service
❑0-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Meters
❑Commercial(Main) Service
00-100 amps 101-150amps ❑151-200amps L, amps ❑CT Service amps
Conductor Type Size
❑Multi-Family(Main)Service
00-100 amps 1110 1-15 Oamps ❑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
k-1wimming Pool ❑ Sign []Smoke Detectors_Qty [I Transformers KVA Ll Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK S
REPAIRS/MISCELLANEOUS
Replace Burnt/Damaged Meter Can ❑Safety Inspection L]Panel Change [I OH to UG
Other: LJ "' ?.,0(
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 V.4 LI to Phone Number
f
Electrical Company &-� ec - C Office Phoney 3 Y Fax
Co. Address: a (/ City —mac. State Zip
License Holder (Print): Z�6zo vy` State Crtification/Registration# Poo o 3
Notarized Signature of License Holder
�ar'i"•.. CHO ROBERTS Sworn and subscribed before his a of we., 20,Z,�
Notary Public-State of Florida
Commission#M Comm.Exp res ugf21,2
Y 022 Signature of Notary Public
..or r`;.••
Bonded through National Notary Assn.