275 4th St ERES19-0268 Replace Insulator ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
r
Lr CITY OF ATLANTIC BEACH ERES19-0268
ISSUED: 9/23/2019
800 SEMINOLE ROAD
±~� 19 ATLANTIC BEACH. FL 32233 EXPIRES: 3/21/2020
MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
ALL WORK MUST CONFORMTO THE CURRENT 6TH EDITIONOF • • rA BUILDING
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH CODE OF ORDINANCES .
ALL CONDITIONS OF • r
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:
275 4TH ST ELECTRICAL RESIDENTIAL REPLACE INSULATOR ON $300.00
SERVICE MAST
TYPE OF i
ZONING: :D •
• • GROUP:
172555 0000 ATLANTIC BEACH
TERRACE
COMPANY: ADDRESS: CITY: STATE: ZIP:
VILANO ELECTRIC INC 14286-19 BEACH BOULEVARD, PMB JACKSONVILLE FL 32250
#394
• A• • • �.
YEAGER GIRARD ALAN 275 4TH ST ATLANTIC BEACH FL 32233-5305
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 • r •
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
Issued Date: 9/23/2019 1 of 2
ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
r S 5 ERES19-0268
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ISSUED: 9/23/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 3/21/2020
TOTAL:$94.00
Issued Date:9/23/2019 2 of 2
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach,FL 32233
'7 RPh(904-)x^247-5826 Fax (904) 247-5845 E RES 9
JOB ADDRESS: L / S L, 5 / PERMIT#
3EA INFORMATION REQUIRED ON ALL PERMITS 2 O O AMPS -24 O VOLTS I PHASE
VALUE OF WORK$ 3 O O . J o
NEW SERVICE ❑ Overhead ❑ Underground ❑1 Underground up Pole
L.Residential (Main)Service
0-100 amps 101-150amps 151-200amps amps #of Meters
Commercial(Main)Service
i0-100 amps 101-150amps 2 151-200amps amps :.CT Service amps
Conductor Type Size
(Multi-Family(Main)Service
i0-100 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 i 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
lleat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
Swimming Pool L' Sign I Smoke Detectors_Qty 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 i.__OH to UG
`<0ther:_ C.j= L r4 7'p IL 0
Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months. 1 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. G-\E J 2ps C 71 (_L,C)
Property Owners Name go S 1= I'" 19 S Phone Number Z-' 4 S Z 3,F S
Electrical Company V, L A w 1- L,4 c r&/ c- 11-' Office Phoneyo4 6 41 0,P6d'Fax6 4 I-q jy)
Co. Address: _l LI a 6 -19 13 L �p_t4t, 3 9 t-I City -Tiat. -State rL Zip 3 ZZ�;'O
License Holder(Print): L A wg lF nrc_ a GL o R.k State Certification/Registration# E C.- O 00A7_1?
Notarized Signature of License Holder4=��
,ONNotary Public State of Florida Sworn and subscribed before me this 9 day o ��X 2019
Laurel Fowler-Heaton
'�;; V m 2 xZ 190867 Signature of Notary Public —