328 10th St ERES19-0229 Pool Elec ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
r CITY OF ATLANTIC BEACH ERES19-0229
ISSUED: 8/5/2019
800 SEMINOLE ROAD`�';»� ATLANTIC BEACH. FL 32233 EXPIRES: 2/1/2020
CODE,MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORM TO THE CURRENT 6TH EDITION (2017) OF THE FLORIDA BUILDING
• OF ' CH 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:
328 10TH ST ELECTRICAL RESIDENTIAL SWIMMING POOL $985.00
ELECTRICAL
TYPE OF
• • GROUP:
170035 0000 ATLANTIC BEACH
COMPANY: ADDRESS:
HAZOURI ELECTRIC, INC. P 0 BOX 56559 JACKSONVILLE FL 32241
• ADDRESS:
DYER KELLY L 328 10TH ST ATLANTIC BEACH FL 32233-5530
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 45S-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $99.00
Issued Date:8/5/2019 1 of 2
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233 p
Ph(904)247-5826 Fax(904) 247-5845 c R CS n _b zzc?
JOB ADDRESS: J ZyQ lo " PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS Zoo AMPS Z -(0VOLTS ` PHASE
VALUE OF WORK$
NEW SERVICE ❑ Overhead ❑ Underground ❑1 Underground up Pole
❑Residential(Main)Service
00-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Meters
El Commercial(Main)Service
00-100 amps ❑101-150amps ❑151-200amps ❑ amps ❑CT Service amps
Conductor Type Size
❑Multi-Family(Main)Service
❑0-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Unit Meters
El 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 El 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 DOH to UG
❑Other: W t
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 Name12,
Phone Number 3_3' to
c� G Office Phone Company Nx
Co.Address: q r/ City State-(Zip
License Holder(Print): 4 - State Certification/Registration# @fid 3
Nitariz Holde
CHO ROBERTS
4f: Notary Public State of Florida Sworn and subscribed before me thi ay 20 A
�j p; Commission p GG 211925
?o My Comm.Expires Aug 21,2022
bonded through National Notary assn. Signature Of Notary PUb11C