2217 Alicia Ln ERES19-0267 Replace Meter Can rt"'''' ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
's � ERES19-0267
CITY OF ATLANTIC BEACH
o �� ISSUED: 9/25/2019
800 SEMINOLE ROAD
1119." ATLANTIC BEACH. FL 32233 EXPIRES: 3/23/2020
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
CODE, NEC, IPMC, AND CITY OF ATLANTIC BEACH 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:
2217 ALICIA LN ELECTRICAL RESIDENTIAL REPLACE METER CAN $1400.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: i NUMBER: GROUP:
169519 0760 TIFFANY BY THE SEA
COMPANY: ADDRESS: CITY: STATE: ZIP:
AMERICAN ELECTRICAL
CONTRACTING, INC. 5065 ST AUGUSTINE RD #13 JACKSONVILLE FL 32207
OWNER: ADDRESS: CITY: STATE: ZIP:
MASHOD SIAMAC 2217 ALICIA LN ATLANTIC BEACH FL 32233-5975
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 CONDITIONS
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: 9/25/2019 1 of 2
1..m,.--N
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!/` Cash Register Receipt Receipt Number
'V a City of Atlantic Beach R10481
DESCRIPTION I ACCOUNT I QTY I PAID
PermitTRAK $94.00
ERES19-0267 Address: 2217 ALICIA LN APN: 169519 0760 $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
TOTAL FEES PAID BY RECEIPT: R10481 $94.00
Date Paid: Wednesday, September 25, 2019
Paid By: AMERICAN ELECTRICAL CONTRACTING, INC.
Cashier: CT
Pay Method: CREDIT CARD 11
Printed:Wednesday,September 25,2019 3:33 PM 1 of 1 L
Electrical Permit Application "ALL INFORMATION
HIGHLIGHTED IN
i. =
' City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 ( ESI - czc„.7
'4' ° Phone: (904) 247-5826�+►Email: Building-Dept@coab.us PERMIT#:
JOB ADDRESS: 221( A\ `C l OL Lar\ PROJECT VALUE $' 9 aQ
52.
JEA INFORMATION REQUIRED ON ALL PERMITS:;;]OD AMPS?A0 VOLTS, PHASE
nNEW SERVICE: 0 Overhead Underground ®Underground up Pole
LResidential(Main)Service:
00-100 amps 0101-150amps 0151-200amps ❑ amps #of Meters
['Commercial (Main)Service:
00-100 amps 0101-150amps 0151-200amps ❑ amps OCT Service amps
Conductor Type Size
OMulti-Family(Main)Service:
DD-100 amps 0101-150amps 0151-200amps ❑ amps #of Unit Meters
0 TEMPORARY POLE: amps
SERVICE UPGRADE: ❑ amps OCT Service amps
❑ NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.):
0100 amps 0150amps 0200amps ❑ amps DT Service amps
❑ ADDITIONS, REMODELS, REPAIRS, BUILD-OUTS, ACCESSORY STRUCTURES, ETC:
Outlets/Switches: 0-30amps 31-100amps 101-200a mps
Appliances: 0-30amps 31-100amps 101-200amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
n
i OTHER ELECTRICAL PROJECTS:
❑Swimming Pool Sign ❑Smoke Detectors (Qty) ❑Transformers KVA ❑Motors HP
n FIRE ALARM SYSTEM (Requires 3 sets of plans):
Qty volts/amps
RAIRS/MISCELLANEOUS:
eplatf Qamggdete ❑Sy Ino � nel Change DOH to UG
❑ ther: y. �\�ct •60oejev
Updated 10/17/18
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 1 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.
wnerNam wJ\GC.-. O.
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Owner Name:; ` Phone Number:
•
Electrical Company:Pir1Q.Y\ LOIN 1 Ck\ c 4 Office Phone:0011Y1571-11.10 Fax:
Co.Address:50 9 S SA.ppi��USAAr\e R do City:L J State: Zip:57,20-1� 3
License Holder: E(��", �4 �T'��.u State Certification/Registration#:��„ , OQ1
Notarized Signature of License Holder j .
The foregoing instrumen a . ...wledged before me this Ci day of 2019, in the State of Florida, County of 0kA\1
Notary Plc State of Honda Signature of Notary Public
Color Bsawn GG 288614
t Expires 10/17/2022 Personally Known OR )Produced Identification
a "T e of Identification: