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10 FORRESTAL CIR - ERES19-0334 oN,,, ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER ..,-3.' ERES19-0334 s7 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ISSUED: 11/20/2019 �''' � ATLANTIC BEACH. FL 32233 EXPIRES: 5/18/2020 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: 10 FORRESTAL CIR ELECTRICAL RESIDENTIAL REPAIR METER JAW AND $300.00 WIRE UP THE MAST TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION: CONSTRUCTION: NUMBER: GROUP: 171763 0000 ATLANTIC BEACH VILLA# 01 COMPANY: ADDRESS: CITY: STATE: ZIP: CRAWFORD ELECTRIC 2301 Marsh Point Road Neptune Beach FL 32266 OWNER: ADDRESS: CITY: STATE: ZIP: SMITH SHARON 10 FORRESTAL CIR N 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. LIST OF CONDITIONS Roll off container company must be on City approved list . Container cannot be placed on City right-of-way. —_.. ✓'., t . "mss * ,� reit i 4 a 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: 11/20/2019 1 of 2 . - Electrical Permit Application **ALL INFORMATION d' 410Ps, HIGHLIGHTED IN City of Atlantic Beach Building Department GRAY IS REQUIRED. ` "* 800 Seminole Rd, Atlantic Beach, FL 32233 E(Z E.,3t U( - 0334 30' Phone:i (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: /L) JOB ADDRESS: r 1 eAr , 32Z33 PROJECT VALUE $ LI n° JEA INFORMATION REQUIRED ON ALL PERMITS: Z O AMPS 21/o VOLTS I PHASE El NEW SERVICE: 0 Overhead ©Underground ❑Underground up Pole OResidential (Main)Service: 00-100 amps 0101-150amps 0151-200amps El amps #of Meters ❑Commercial (Main)Service: 1:30-100 amps 0101-150amps 0151-200amps 0 amps OCT Service amps Conductor Type Size OMulti-Family(Main) Service: 00-100 amps 0101-150amps 0151-200amps 0 amps #of Unit Meters TEMPORARY POLE: amps ❑SERVICE UPGRADE: 0 amps OCT Service amps ❑ NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.): 0100 amps 0150amps 0200amps 0 amps OCT Service amps El 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: ['Swimming Pool['Sign ❑Smoke Detectors (Qty) ❑Transformers KVA ['Motors HP ❑ FIRE ALARM SYSTEM (Requires 3 sets of plans): t7�r Qty volts/amps ; 11 Mk A/1111\ n REPAIRS/MISCELLANEOUS: ■Replace Bur-tt/Damaged Meter Can ❑Safety Inspection ❑Pan;I Chang_ 00Hto UG - //pp ether: 0f t11k C' �c1 4 r " ll Vl'li. �`,!ryll� I `�y\ ac 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: UcWA& A'\i Phone Number: f...9"/-2D- {,jElectrical bagCompany: Office Phone: qdy- scy/; Fax: Co. • Address: 2�\ L a ?fh City: 4/ t gP ✓ State: Zip: 2h7 License Holder: 1, State 1 Certification/Registration#: t {� �t- t ---e -Notarized Signature of License Holder 41 16� cL - c'uci . . dged before me this \�da of \IN , 20 Ili, in a State of Florida, County of Dttal :`Ns:t ,, JILLIAN WALKER /L ''�� MYCOMMISSIONS0000611t Signature of Notary Publi �(�.,((/I, -:..7-:a f EXPIRES:June 27,2020 '••.,,pr.;t:° Bated' uNotaryPublicUndemitsrs 94 Personally Known OR [ ] roduced Identification ype of Identification: