2233 Seminole Rd ERES19-0263 Moving Wire ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH ERES19-0263
800 SEMINOLE ROAD
ISSUED: 9/16/2019
\ry�9109 ATLANTIC BEACH. FL 32233 EXPIRES: 3/14/2020
MUST CALL INSPECTION * • + BY 4 PM FORINSPECTION.
ALL • 'K MUST CONFORM TO THE CURRENT 6TH EDITION1 OF • ' D+ BUILDING
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL • • OF PERMIT • • 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:
2233 SEMINOLE RD 29 ELECTRICAL RESIDENTIAL MOVING WIRE AT SOFFIT $1200.00
TYPE OF
CONSTRUCTION: NUMBER: G
169519 0156 OCEAN VILLAGE ONE
CONDO
COMPANY: . ADDRESS:
LIN'S ELECTRIC INC 3840 MAGILL ROAD JACKSONVILLE FL 32220
• ADDRESS:
BROWN BEVERLY S 2233 SEMINOLE RD #29 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 REPAIRS AND MISC 455-0000-322-1000 0 $35.00
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: $94.00
Issued Date:9/16/2019 1 of 2
ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
ERES19-0263
s CITY OF ATLANTIC BEACH
yr 800 SEMINOLE ROAD ISSUED: 9/16/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 3/14/2020
Issued Date: 9/16/2019 2 of 2
* IINFORMATION
Electrical Permit Application HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 SIg - U Z 63
Phone: (904) 247-5826 Email: Building-Dept2coab.us PERMIT#:
:)B ADDRESS: 2233 Seminole Rd. ZVj PROJECT VALUE $$ 1,200.00
JEA INFORMATION REQUIRED ON ALL PERMITS: 200 AMPS 240 VOLTS 1 PHASE
❑ NEW SERVICE: F1 Overhead ❑Underground ❑Underground up Pole
residential (Main)Service:
❑0-100 amps a01-150amps [3151-200amps ❑ amps #of Meters
[--)Commercial (Main) Service:
❑0-100 amps E3101-150amps E1151-200amps ❑ amps ❑CT Service amps
Conductor Type Size
❑Mufti-Family(Main) Service:
❑0-100 amps [1101-150amps 171151-200amps [—]_amps #of Unit Meters
❑ TEMPORARY POLE: amps
❑ SERVICE UPGRADE: ❑ amps ❑Cf Service amps
❑ NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.):
❑100 amps ❑150amps 0200amps ❑ amps []CTService 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:
❑Replace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change []OH to UG
✓❑Dther:Moving wire in order to remove soffit Updated 10/17/18
ermit 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
tad 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
pecified 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
onstruction. `^ 1 " Lhe-,-"j ' '904 361-8207
)wner Name: Bart BOutwell ��I'to (— �J�a Pi!�(at t Phone Dumber: ( )
lectrical Company: Lin's Electric Inc. Office Phone: (904)869-6586 Fax:
o.Address: 3840 Magill Rd. City: Jacksonville State: FL Zip: 32220
icense Holder: Virgil L. Rhoden State Certification/Registration#: EC13007419
lotarized Signature of License Holdera �✓��
he foregoing instrument was acknowledged before me this_��day of 20 `1 in the SVat;of Florida, County of
LESLIE Signature of Nota Public �1�ul
LEL. SMITH g Notary
My COMMISSION#GG095760
'?'o;tid ' EXPIRES April 28,2021 Personally Known OR ( ) Produced Identification
Type of Identification:
J' r
7 • Receipt
City'✓ s1
ofAtlanticBeach R10277
DESCRIPTION ACCOUNT CITY PAID
PermitTRAK $94.00
ERES19-0263 Address: 2233 SEMINOLE RD 29 APN: 169519 0156 $94.00
ELECTRICAL $90.00
ELECTRICAL BASE FEE 455-0000-322-1000 0 $55.00
ELEC REPAIRS AND MISC 455-0000-322-1000 0 $35.00
STATE SURCHARGES $4.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL1 11
Date Paid: Monday, September 16, 2019
Paid By: LIN'S ELECTRIC INC
Cashier: CT
Pay Method: CREDIT CARD 011270
Printed: Monday,September 16,2019 11:41 AM 1 of 1