390 Main St ERES19-0288 Safety r1'pL�r%c ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
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CITY OF ATLANTIC BEACH ERES19-0288
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800 SEMINOLE ROAD ISSUED: 10/7/2019
`:1-oV ATLANTIC BEACH. FL 32233 EXPIRES: 4/4/2020
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:
390 MAIN ST ELECTRICAL RESIDENTIAL SAFETY INSPECTION $250.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
170900 0600 ATLANTIC BEACH SEC H
COMPANY: I ADDRESS: CITY: STATE: ZIP:
KNIGHT ELECTRIC LLC 908 S 11TH AVE JACKSONVILLE FL 32250
BEACH
OWNER: ADDRESS: CITY: STATE: ZIP:
SUMLIN ARCHIE L SR 390 MAIN ST ATLANTIC BEACH FL 32233-2530
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.
,,hH �_ 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
ELECTRICAL BASE FEE 455-0000 322-1000 0 $55.00
SAFETY INSPECTION 455-0000-322-1000 0 $50.00
STATE DBPR SURCHARGE 455 0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000 208-0600 0 $2.00
TOTAL: $109.00
Issued Date: 10/7/2019 1 of 2
i' A0, ,,'`'J ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
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CITY OF ATLANTIC BEACH ERES19-0288
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800 SEMINOLE ROAD ISSUED: 10/7/2019
`,..,1.9119)/ ATLANTIC BEACH. FL 32233 EXPIRES: 4/4/2020
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Issued Date: 10/7/2019 2 of 2
Cash Register Receipt Receipt Number
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City of Atlantic Beach R10676
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DESCRIPTION I ACCOUNT I QTY I PAID
PermitTRAK $109.00
ERES19-0288 Address: 390 MAIN ST APN: 170900 0600 $109.00
ELECTRICAL $105.00
ELECTRICAL BASE FEE 455-0000-322-1000 0 $55.00
SAFETY INSPECTION 455-0000-322-1000 0 $50.00
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: R10676 $109.00
Date Paid: Monday, October 07, 2019
Paid By: KNIGHT ELECTRIC LLC
Cashier: CT
Pay Method: CREDIT CARD 043623
Printed: Monday,October 07, 2019 3:37 PM 1 of 1
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HIGHLIGHTED IN
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City of Atlantic Beach Building Department GRAY IS REQU RED.
800 Seminole Rd,Atlantic Beach, FL 32233 n. S
Phone: (904) 247-5826 Email: liw,ildi,r g Dppt.(tvf_p_ab.-us PERIMITk: E1 ` `� "OzOy0
JOB ADDRESS: 'Q n'-1Cj\in, -1 PROJECT VALUE$ f�3(_)
JEA INFORMATION REQUIRED ON ALL PERMITS:1e)AMPS' V()/OLTS I PHASE
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❑ NEW SERVICE: 0 Overhead oUnderground tiUnderground up Pole
uResidentlal(Main)Service:
110-100 amps n101-150amps u1S1-200amps to amps fl of Meters
rlCommercial(Main)Service:
c10-100 amps r:101-150amps i 151.200amps t: __amps riCT Service amps
Conductor Type Size
oMultl-Family(Main)Service:
o0-100 amps n101-150amps '3151-200amps amps ft of Unit Meters
ill TEMPORARY POLE: amps
r l SERVICE UPGRADE: u_ amps nCT Service _ amps
L NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.):
u100 amps ;:1150amps n200amps i.i amps cCTService amps
❑ADDITIONS,REMODELS, REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES, ETC:
Outlets/Switches: 0.30amps __31.100arnpsP 31•100ams 101-200amps �
Appliances: _0-30am s _ p __ _101-200amps
A/C Circuits: _ 0-60amps 61.100amps
Heat Circuits: +It circuits t kw
Number of Light Inc Outlets, Including Fixtures._
OTHER ELECTRICAL PROJECTS:
',Swimming Pool r;Sign tuSmoke Detectors__ (Qty) t.Transformers KVA Motor HP
fl FIRE ALARM SYSTEM(Requires 3 sets of plans)
Qty ___.-__volts/amps
)REPAIRS/MISCELLANEOUS: , r
,Replace Burnt/Damaged Meter Can S fety Inspection ;iPanel Change ❑OH to UG
I Other: Updated 10/17/28
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Permit becomes void If work does not commence within a six month period or work Is suspended or abandoned for six months. t hereby certify that I have
read this application and know the same to he true and correct All provisions of laws and ordinances governing this work will be complied with whether
specified or riot. The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of
construction.
Owner Name: Phone Number:
Electrical Company: 1 -1\c" -- - [�\.f C\Y X I1Ci Office Phone: ?1-1-c 9 / Fax:'—>1751k
aax: l
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Co.Address: CgCtt? 1) 11'v f Kj, City; ((1_..> f
State: Zip; �dsl}SG
License Holder: .• it _./.--- State Certification/Registration n: I?(..114) s;
Motorized Signature of License Holder �•�4
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The foregoing instrument was acknowledged before me this . day o Pjr COI, 20 ri,in the Sta of Florida, . . o!
Signa re of Notary Public
( Personally Known OR J J Produced Iden'. !'/
Type of Identification:
ma Tracey Paulsen
~r0 NOTARY PUBLIC
�J�(. , STATE OF FLORIDA
si��gt0 Expires 4/30/2022