1175 Seminole Rd ERES19-0296 Panel Change r�'�''''rr,j
ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
R' � � ERES19-0296
rv. s, CITY OF ATLANTIC BEACH
r ISSUED: 10/8/2019
800 SEMINOLE ROAD
"-zi.n»r ATLANTIC BEACH. FL 32233 EXPIRES:4/5/2020
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:
1175 SEMINOLE RD ELECTRICAL RESIDENTIAL ELECTRIC PANEL CHANGE $800.00
TYPE OF REAL ESTATE 1 BUILDING USE
CONSTRUCTION: NUMBER: ZONING: GROUP: SUBDIVISION:
171890 0000 SELVA MARINA UNIT 01
COMPANY: ADDRESS: CITY: STATE: 11E211
UNITED ELECTRIC
COMPANY OF 5716 SAINT AUGUSTINE ROAD JACKSONVILLE FL 32207
JACKSONVILLE
OWNER: I ADDRESS: 4 CITY: STATE: ZIP:
MCKIMM ROBERT III 1175 SEMINOLE RD 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 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: $94.00
Issued Date: 10/8/2019 1 of 2
S_ Jr;;, Electrical Permit Application "ALL INFORMATION
HIGHLIGHTED IN
f---'
_ "•
,,_ ),?,) City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 4,
Phone: (904) 247-5826 Email: Buildi ��� ` - Z�`�
Building-Uept@coab.us PERMIT
JOB ADDRESS: \V-1 5 S e_m;,\ 0 1 c 12-J PROJECT VALUE$ 'O O , (9 O
JEA INFORMATION REQUIRED ON ALL PERMITS: 150 AMPS 90 VOLTS I PHASE
❑ NEW SERVICE: 0 Overhead ❑Underground DUnderground up Pole
OResidential(Main)Service:
00-100 amps 0101-150amps D151-200amps ❑ amps #of Meters
❑Commercial(Main)Service:
00-100 amps 0101-150amps 0151-200amps D amps OCT Service amps
Conductor Type Size
❑Multi-Family(Main)Service:
00-100 amps 0101-150amps 9151-200amps ❑ amps #of Unit Meters
ri TEMPORARY POLE: amps
El SERVICE UPGRADE: ❑ amps ECT Service amps
n NEW FEEDER (ADDITIONS,ACCESSORY STRUCTURES, ETC.):
❑100 amps 0150amps 1:1200amps ❑ amps OCT Service amps
idADDITIONS,
I ADDITIONS, REMODELS, REPAIRS, BUILD-OUTS,ACCESSORY STRUCTURES, ETC:
Outlets/Switches: 3 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: I
U 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 anel Change DOH to UG
[Other: / `) 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 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. `,
Owner Name: V A I e r I LL k4/-14-
1, (h ( ' (r ? Phone Number: J O - -7 5 f/ 9
Electrical Company: U/1; +til e)t C T r- t- (,O e t lJ" Office Phone: 13 ) - 12-' 0 Fax: 73) -53 ) )
Co.Address: 57 ) 1 S -I- iqu,,us 4-JI� IZ City: a..' ic State: Q- Zip: 3Z Z 0 3
License Holder: N , m i (✓k (14_ l A d/A,14 /
G mSso State Certification/Registration#: e-1 30 QNotarized Signature of License Holder, 7, 't
The foregoing instrument was acknowledged before me this D day of Q(i 220 °! ininthe Stateatof Flori ,County of D,)✓u 1
Signatur of Notary Public 13,7 �L /` <J d -
r°K��"� BRENDA K. GRIFFIN [ ersonally Known OR[ I Produced Identification
oikMY COMMISSION#GG193986 Type of Identification:
-,,,,S EXPIRES April 23,2022