1555 Selva Marina Dr ERES19-0305 Electric Remodel rI'-`'N% ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
J ? ` S
. ' CITY OF ATLANTIC BEACH ERES19-0305
Ur, ISSUED: 10/15/2019
800 SEMINOLE ROAD
X ;3»" ATLANTIC BEACH. FL 32233 EXPIRES: 4/12/2020
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:
ELECTRIC REMODEL- 60
1555 SELVA MARINA DR ELECTRICAL RESIDENTIAL FIXTURES $2350.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
171946 0000 SELVA MARINA UNIT 02
COMPANY: ADDRESS: CITY: STATE: ZIP:
A.G.S. Electrical and
Property 3820 Williamsburg Pk. Blvd. #4 Jacksonville FL 32257
OWNER: ADDRESS: CITY: STATE: ZIP:
ARTHUR RICHARD
WORSHAM 1555 Selva Marina Dr 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.
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 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 C $2.00
Issued Date: 10/15/2019 1 of 2
It;j2N ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
r. : CITY OF ATLANTIC BEACH ERES19-0305
I
800 SEMINOLE ROAD
ISSUED: 10/15/2019
T-k
`c)13 ,— ATLANTIC BEACH. FL 32233 EXPIRES:4/12/2020
TOTAL: $94.00
Issued Date: 10/15/2019 2 of 2
S�a.r Electrical Permit Application **ALL INFORMATION
;''/,,, '-�,� HIGHLIGHTED IN
`;� City of Atlantic Beach Building Department GRAY IS REQUIRED.
r,
lW / 800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: BuildinDept@coab.us PERMIT$t:
JOB ADDRESS: ‘6,5 ‘.5L�A00, AOS\(ka_ ` c")1\Y3 PROJECT VALUE$ ,
il JEA INFORMATION REQUIRED ON ALL PERMITS: /AIjAMPSA(4()VOLTS 1 PHASE
❑ NEW SERVICE: VOverhead EUnderground ❑Underground up Pole
❑Residential (Main)Service:
❑0-100 amps o101-150amps D151-200amps ❑ amps #of Meters
❑Commercial (Main)Service:
❑O-100 amps D101-150amps D151-200amps ❑ amps DCT Service amps
Conductor Type Size
❑Multi-Family(Main)Service:
❑O-100 amps D101-150amps o151-200amps D amps #of Unit Meters
TEMPORARY POLE: amps
❑ SERVICE UPGRADE: ❑ amps DCT Service amps
❑ NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.):
❑100 amps ❑150amps ❑200amps ❑ amps DCT Service amps
i I ADDITIONS, REMO, REPAIRS, BUILD-OUTS,ACCESSORY STRUCTURES, ETC:
Outlets/Switches: _ 0-30amps 31-100amps 101-200amps
Appliances: 6 0-30amps —31-100amps 101-200amps
A/C Circuits: JP; 0-60amps 61-100amps
Heat Circuits: �. # circuits @ WIlT w U,
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS)/
❑Swimming Pool ❑Sign 3&6oke Detectors (Qty) ❑Transformers KVA ❑Motors HP
FIRE ALARM SYSTEM (Requires 3 sets of plans):
Qty volts/amps
REPAIRS/MISCELLANEOUS: N(.j
❑Re ce Bur' 1amageo - erC.n ❑ afet In r- •• , < •- •. •. _e • UG
ther: �S' - "' ,,.11,, te — Updated 10/17/18
Permit becomes void if work does not commence within a six month period . work is suspended or aba doned 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 rmit does not give uthorit to vi I to the provisions of any other state or local law regulatio constru ion .r tie .erformanc• of
construction. I (\ — r
Owner Name: •h.n Number: _ i ,� �`I
Electrical Company: i;'o kF €C1 ., . Office Phone I i LI • Fax:
Co.Address: �, £ )\ IG S City: a Stat-:
, Zip: I
License Holder: d. fat tlt. _,LI ` Certification/Registration Sta - #: & /
Notarized Signature of License Holder t, a,d ori S ,
The foregoing instrument was acknowledged b:/.re me this I •.y . 4IM. J 20 In the State of Fl. ... County of
...�— '"I J V' Sig ature of Notary Public i 1 Z.---
�.!5?c , TONI GI DLESPERGER di
*: :+ �IyOpCOMMISSION [ ] Personally Known OR[ ] Produced Identification
,5:.%PS: EXPIRES:Ocfobsr6,2023 Type of Identification: l_.
7,,,,tk, Bonded lin Notary public Undemiters