644 BEACH AVE - ERES19-0330 ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
/411* I\
CITY OF ATLANTIC BEACH ERES19-0330
ISSUED: 11/19/2019
800 SEMINOLE ROAD
ATLANTIC BEACH. FL 32233 EXPIRES: 5/17/2020
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:
644 BEACH AVE ELECTRICAL RESIDENTIAL REPLACE METER CAN - $500.00
UNDERGROUND
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
170125 0000 DANIEL& HACKETT R/P
BK16
COMPANY: ADDRESS: CITY: STATE: ZIP:
STEWART ELECTRICAL GREEN COVE
545 NORTH PALMETTO AVENUE FL 32043
CONTRACTORS, INC. SPRINGS
OWNER: ADDRESS: CITY: STATE: ZIP:
HUTCHINSON HENRIETTA S 644 BEACH AVE ATLANTIC BEACH FL 32233-5326
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 $2.00
Issued Date: 11/19/2019 1 of 2
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach,FL 32233
'/ Ph(904)247-5826 Fax (904)247-5845 E ES( 1-O37J
JOB ADDRESS: 6o 15e i (i ✓e PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS ✓. AMPS ?i`'' VOLTS PHASE
VALUE OF WORK$ .5
NEW SERVICE ( I Overhead ❑ Underground ❑J Underground up Pole
LResidential(Main)Service
❑0-100 amps 0101-1St/amps []151-200amps amps #of Meters
❑Commercial(Main)Service
00-100 amps ❑101-150amps ;7151-200amps amps CI'Service amps
Conductor Type Size
❑Multi-Family(Main)Service
00-100 amps -101-150amps 151-200amps amps #of Unit Meters
❑Temporary Pole Lamps
SERVICE UPGRADE amps CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
100 amps1150amps =200amps amps OCT Service amps
ADDITIONS,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
0 Swimming Pool n Sign " 'Smoke Detectors _Qty Transformers KVA Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCE
Replace B •04a...led' : . :edd Meter C. ❑Safety Inspection :Pan/el Change OOH to UG
i]Other: se/v,& -4404. 014,/ I-(€ L {.0LG'L citot�b� eels /1G vV fr2G' P///
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. L�
Property Owners NameS<'�,d f A It,f V t t ,.5, Phone Number yam-ZYi`S 3
ec
Electrical Company ' i "'#' r /ret 3-1c Office Phoney/y ?i)-1;a6 Fax
Co.Address: S 475 f l C Tro City_6( S _ State J( Zip 32.,0Y?
License Holder(Print): D v �jlrS4/ State -.;' • '•_ ,' ` ion# E /3*05" 6/
Notarized Signatwe of License Holder /a`t, +\ ss;�%
Sworn ands bed befv;if
,�.i s:7",• ` GI/ 20 r'y
Signature of Notary Public /