250 Beach Ave ERES19-0324 A/C Breaker Change ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH
ERES19-0324
800 SEMINOLE ROAD ISSUED: 10/31/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 4/28/2020
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:
250 BEACH AVE ELECTRICAL RESIDENTIAL A/C BREAKER CHANGE $150.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
170195 0000 ATLANTIC BEACH
COMPANY: ADDRESS: CITY: STATE: ZIP:
ELECTRIC PLUS 11199 LAKE BLUFF RD JACKSONVILLE FL 32257
OWNER: ADDRESS: CITY: STATE: ZIP:
WEED WENDY A 250 BEACH AVE ATLANTIC BEACH FL 32233-5214
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 TRANSFORMERS 455-0000-322-1000 1 $4.00
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:$63.00
Issued Date: 10/31/2019 1 of 2
y`''_'I' l ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER CITY OF ATLANTIC BEACH
�� ERES19-0324
re
\ 800 SEMINOLE ROAD ISSUED: 10/31/2019
• j � EXPIRES: 4/28/2020
ATLANTIC BEACH. FL 32233
Issued Date: 10/31/2019 2 of 2
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach,FL 32233
Ph(904)247-5826 Fax(904)247-5845 FRES \9 - 03E4
JOB ADDRESS: PCO 'BPQeh Pve, -(qn'�'L �/ PI- PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS 'dry) AMPS a 10 VOLTS I PHASE
VALUE OF WORKS 150 —
NEW SERVICE E Overhead ❑ Underground ❑I Underground up Pole
OResidential(Main)Service
00-100 amps ❑101-150amps 0151-200amps ❑ amps #of Meters
❑Commercial(Main)Service
00-100 amps ❑101-150amps 0151-200amps 0 amps OCT Service amps
Conductor Type Size
0Multi-Family(Main)Service
00-100 amps 0101-150amps 0151-200amps 0 amps #of Unit Meters
OTemporary Pole 0 amps
SERVICE UPGRADE ❑ amps 0 CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
01110 amps. ❑i 50amps 0200amps 0 amps OCT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-3 Oamps 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:
OTHER ELECTRICAL PROJECTS
❑Swimming Pool 0 Sign ❑Smoke Detectors_Qty OTransformers KVA ❑Motors lip
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK S
REPAIRS/MISCELLANEOUS
❑Replace Burnt/Damaged Meter Can
❑Saff ety Inspection ❑Panel Change ❑OH to UG
� �( ( C Pe'Gd.
ther: I�l rk _'' C an 5-e--
Permit
-_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. / (� ,�p.
Property Owners Name Rc tial& C &vt�cn Phone Number °IOy'6P30 — 54 2$__
Electrical Company El-e C'l-rt C fl US TNI C • __Office Phone gf 3 ?*. ..yqFax
Co.Address:j(I q LQ^C 61,i R , City Soli State\ Zip 3 a .S 7
License Holder(Print):Iilj C tlick vvl /. kr JSG_L' jtate Cc ification/Registration# g a6 3C) I 39
Vo rr . . h/er >N 4 r
Cyt hir, •Notary Pudic State of Floods
Shirley L Graham 4 efore me this_ _day t, 1
1:- p` My Commivan FF 096990 �� Ai
�c:nd F..mrn,02/14/2010
Signature of Notary Pu :c i `• 4111h1 .4
J rS i,-.
s Recei t Number
t� Cash Register Receipt p
k� �/ City of Atlantic Beach R10919
oii 9
DESCRIPTION I ACCOUNT I QTY I PAID
PermitTRAK $63.00 1
ERES19-0324 Address: 250 BEACH AVE APN: 170195 0000 $63.00
ELECTRICAL $59.00
ELECTRICAL BASE FEE 455-0000-322-1000 0 $55.00
ELEC TRANSFORMERS 455-0000-322-1000 1 $4.00
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: R10919 $63.00
Date Paid: Thursday, October 31, 2019
Paid By: ELECTRIC PLUS
Cashier: CB
Pay Method: CREDIT CARD 1
Printed:Thursday,October 31, 2019 9:58 AM 1 of 1