360 1st St ERES19-0318 Elec for Kitchen Remodel 'rmir,,r,� ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
r, CITY OF ATLANTIC BEACH ERES19-0318
kaPi-
800 ISSUED: 10/29/2019
+ , SEMINOLE ROAD EXPIRES: 4/26/2020
ATLANTIC BEACH. FL 32233
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:
360 1ST ST ELECTRICAL RESIDENTIAL ELECTRIC KITCHEN REMODEL $2500.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
169750 0000 ATLANTIC BEACH
COMPANY: ADDRESS: CITY: STATE: ZIP:
FRANKLIN ELECTRIC JACKSONVILLE
930 10th Street FL 32250
SERVICE BEACH
OWNER: ADDRESS: CITY: STATE: ZIP:
DAVID W NEWMAN 360 1ST ST ATLANTIC BEACH FL 32233-5347
REVOCABLE TRUST
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.
FEES
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: 10/29/2019 1 of 2
Electrical Permit Application **ALL INFORMATION
fi...:,... HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 RF . (C1 -C7`
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: ESP -' 0319'
JOB ADDRESS: 360 1st Street PROJECT VALUE$$2.500.00
JEA INFORMATION REQUIRED ON ALL PERMITS: 200 AMPS 240 VOLTS 1 PHASE
1] NEW SERVICE: 0 Overhead ❑Underground ❑Underground up Pole
Otesidential(Main)Service:
❑0-100 amps 0101-150amps 0151-200amps El amps #of Meters
❑Commercial (Main)Service:
❑0-100 amps 0101-150amps 0151-200amps 0 amps OCT Service amps
Conductor Type Size
❑Multi-Family(Main)Service:
❑0-100 amps 0101-150amps D151-200amps 0 amps #of Unit Meters
❑TEMPORARY POLE: amps
El SERVICE UPGRADE: ❑ amps OCT Service amps
NEW FEEDER (ADDITIONS,ACCESSORY STRUCTURES, ETC.):
❑100 amps 0150amps D200amps ❑ amps OCT Service amps
❑ ADDITIONS, REMODELS, REPAIRS, BUILD-OUTS,ACCESSORY STRUCTURES, ETC:
Outlets/Switches: 0-30a mps 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 OTHER ELECTRICAL PROJECTS:
❑Swimming Pool OSign ❑Smoke Detectors (Qty) ❑Transformers KVA ❑Motors HP
E FIRE ALARM SYSTEM (Requires 3 sets of plans):
Qty volts/amps
n REPAIRS/MISCELLANEOUS:
DReplace Burnt/Damaged Meter Can ❑Safety Inspection DPanel Change DOH to UG
❑Jther:Kitchen Remodel 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: David Newman Phone Number: 208-1084
Electrical Company: Franklin Electric Office Phone: 629-4925 Fax:
Co.Address: P.O Box 51237 City: Jax Beach State: FL Zip: 32240
License Holder: Jarrett Franklin State Certification/Registration#: ER13013898
Notarized Signature of License Holde - ' / �y��—
The foregoing instrument was acknowl b- ore • - this 2.Qday U1.�1 0i�n in the State a arida,County of 5 .---- 5
Signature of Notary Publi c.X((�� • a_ t ! .• S .
i t I I
:off.14, Notary Public State o1 Florida .
Tara L Batten-selmudez
'A ,, 4 My Commission GG 112881 Personally Known OR[ J Produced Identification
'+'to,,,pc Expires 06/08/2021 ype of Identification:
iit
Cash Register Receipt Receipt Number
l4;:
uv City of Atlantic Beach R10867
----tort !r
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $94.00
ERES19-0318 Address: 360 1ST ST APN: 169750 0000 $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: R10867 $94.00
Date Paid: Tuesday, October 29, 2019
Paid By: FRANKLIN ELECTRIC SERVICE
Cashier: CT
Pay Method: CREDIT CARD 080931
or
Printed:Tuesday,October 29,2019 8:50 AM 1 of 1 il