671 Amberjack Ln ERES19-0326 Elec for Addition _ _ .
r,SQL' ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
f ��,� ERES19-0326
`"t CITY OF ATLANTIC BEACH
\r /" ISSUED: 11/6/2019
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800 SEMINOLE ROAD EXPIRES: 5/4/2020
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:
671 AMBERJACK LN ELECTRICAL RESIDENTIAL ELECTRIC FOR ADDITION $2000.00
TYPE OF 1 REAL ESTATE 1 ZONING: i BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
171190 0000 ROYAL PALMS UNIT 01
COMPANY: ADDRESS: CITY: STATE: ZIP:
Cavan Electric, Inc. 2201 Edison Avenue Jacksonville Fl 32204
OWNER: ADDRESS: CITY: STATE: ZIP:
KING ADAM J 671 AMBERJACK LN ATLANTIC BEACH FL 32233-4202
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: $94.00
Issued Date: 11/6/2019 1 of 2
1r% ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
ERES19-0326
1 s� CITY OF ATLANTIC BEACH
ISSUED:SEMINOLE ROAD 11/6/2019
oa»r ATLANTIC BEACH. FL 32233 EXPIRES: 5/4/2020
Issued Date: 11/6/2019 2 of 2
••ALL INFORMATION
,, .L Electrical Permit Application ::'
-iiidi 14Wf ED City of Atlantic Beach Building Department k`tiuif►sREtfuiRr ,.''d
v. 800 Seminole Rd, Atlantic Beach, FL 32233 ER-05( A _03 Z c
Phone: (904)��y247-5826 Email: Building-Dept@coab.us PERMIT#: ,
JOB ADDRESS. '4'7! HN+ ,r')4�' •Lo,,�'.'...,;;G-W& c.� . J :° y:>f PROJECT VALUE$ `ert:7�:M
. 2-1.-33k
JEA INFORMATION REQUIRED ON ALL PERMITS: < .....r;„AMPS M,,4",i VOLTS 1 PHASE
0 NEW SERVICE: 0 Overhead OUnderground ['Underground up Pole
atesidential(Main)Service:
00-100 amps 0101-150amps 0151-200amps 0 amps #of Meters
°Commercial(Main)Service:
00-100 amps 0101-150amps 0151-200amps 0 amps OCT Service amps
Conductor Type Size
°Multi-Family(Main)Service:
00-100 amps 0101-150amps 0151-200amps 0 amps #of Unit Meters
0 TEMPORARY POLE: amps
❑SERVICE UPGRADE: ❑ amps OCT Service amps
❑ NEW FEEDER (ADDITIONS,ACCESSORY STRUCTURES, ETC.):
0100 amps 0150amps 0200amps 0 amps [TCT Service amps
XADDITIONS,REMODELS,REPAIRS, BUILD-OUTS,ACCESSORY STRUCTURES, ETC:
Outlets/Switches: 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:
OTHER ELECTRICAL PROJECTS:
❑Swimming Pool['Sign E Smoke Detectors (Qty) ❑Transformers KVA ❑Motors HP
n FIRE ALARM SYSTEM (Requires 3 sets of plans):
Qty volts/amps
0 REPAIRS/MISCELLANEOUS:
❑Replace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change 00H 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: ..• ;�� . . . .fi::, ,`'Phone Number: ar , -.:Y. ' _ .
Electrical Company; a� a"i;i.` `ri t::: l .: .. -�o.1:41:14 1944.:=:'-• Fax:
C 11 �t ' Office Phone: • .. • ,,c...
Co.Address; Xao .., SeA ` . L _ . : City. . , 1/ .ibk.A c;4...:i: State: ft Zip. _ Z0$I ii
License Holder: 717?a/'rn #ter .: ' ''' *.r7.777-
� - . State Certification/Registration#. . -, a.0,7O I.a4c
�'./ /` r.: .r Y ! �Y ifi fr ...<'r! i ♦ '-° r
Notarized Signature of License Holder ` ,, . . .. - _ ..;.., . ..:. ,,..:_ - ,.� ` '.
The foregoing instrument was acknowledged before me this JC day of /VOW. ,20/1,in the State of Florida,County of A/1641./
Signature of Notary Public - Q 9(1.44=4V
,t40 Puss JENNIFER R ORECCO
Se Personally Known OR[ j oduced Identification 23__.....tAte COMMISSION N GG 057948
Type of identification: .it, �.�4 t tXPirttS:January2.NTi-
�"t OF FOP
O PP Bonded Ties Budget Notary Services
,3'r1 r1'J' tJ
Cash Register Receipt Receipt Number
' f ` �r City of Atlantic Beach R1O988
ofil_
DESCRIPTION I ACCOUNT QTY PAID
PermitTRAK $94.00
ERES19-0326 Address: 671 AMBERJACK LN APN: 171190 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: R10988 $94.00
Date Paid: Wednesday, November 06, 2019
Paid By: KING ADAM 1
Cashier: CT
Pay Method: CREDIT CARD 008097
Oie
Printed:Wednesday, November 06, 2019 10:55 AM 1 of 1 IF