1619 BEACH AVE - ERES19-0350 /'v''\`<< ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
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CITY OF ATLANTIC BEACH ERES19-0350
?. ISSUED: 12/11/2019
800 SEMINOLE ROAD
`��;tly ATLANTIC BEACH. FL 32233 EXPIRES: 6/8/2020
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:
1619 BEACH AVE ELECTRICAL RESIDENTIAL MASTER RISER AND $500.00
WEATHER HEAD
TYPE OF I REAL ESTATE 1 ZONING: " BUILDING USE SUBDIVISION:
CONSTRUCTION: I NUMBER: GROUP:
169648 0000 NORTH ATLANTIC BCH
UNIT 1
COMPANY: ADDRESS: CITY: STATE: ZIP:
ALLSTATE ELECTRICAL CTR P 0 BOX 550617 JACKSONVILLE FL 32255
INC.
OWNER: I ADDRESS: CITY: STATE: ZIP:
MOODY DOUGLAS W 1619 BEACH AVE 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.
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
•
f STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
Issued Date: 12/11/2019 1 of 2
8Electrical Permit Application **ALL INFORMATION
f�L'l r
�4' " HIGHLIGHTED IN
S City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 c' c
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:
JOB ADDRESS: `/�/ / 2P,aJJ-) PROJECT VALUE$ 0e0cbD
JEA INFORMATION REQUIRED ON ALL PERMITS: ad AMPS 2/4)VOLTS J PHASE
17 NEW SERVICE: ❑Overhead ❑Underground ❑Underground up Pole
❑Residential(Main)Service:
❑O-100 amps D101-150amps 0151-200amps Cl amps #of Meters
❑Commercial (Main)Service:
❑0-100 amps 0101-150amps D151-200amps ❑ amps DCT Service amps
Conductor Type Size
❑Multi-Family(Main)Service:
00-100 amps 1:1101-150amps D151-200amps El amps #of Unit Meters
n TEMPORARY POLE: amps
SERVICE UPGRADE: El amps OCT Service amps
NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.):
0100 amps 0150amps ❑200amps El amps ET Service amps
❑ ADDITIONS, REMODELS, REPAIRS, BUILD-OUTS,ACCESSORY STRUCTURES, ETC:
Outlets/Switches: 0-30a m ps 31-100amps 101-200a m ps
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[]Sign ❑Smoke Detectors (Qty) ❑Transformers KVA ['Motors HP
FIRE ALARM SYSTEM (Requires 3 sets of plans):
Qty volts/amps
WEPAIRS/MISCELLANEO_US:
EltreTlace Burnta ed Meter Car ❑Safety Inspection EPanel Change ❑OH to UG
ts,t� 1,4, 4_11.4,- Updated 10/17/18
they: (�'YiS�-.
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:-Do Phone Number: 9c- 3'*
-73Y5
Electrical Company: ALLSTATE ELECTRICAL CONTRACTORS, INCOffice Phone: 904-296-2700 Fax:904-296-3471
Co.Address: 7447 SALISBURY RD / City: JACKSONVILLE State: FL Zip: 32256
License Holder: (../i91'2/11 S L ( t., l///a tits//-- )) State Certification/Registration#: e' ']
-bell
Notarized Signature of License Holder dP714. (' Z-e-
The foregoing instrument was acknowledged before me this l�day of ' •' ,20/q , in the State of Florida, County of/00-1
��vvus7 IRISANDINO Signature of Notary Public *�—�
r°.' �' ¢ Commission#GG 305213
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`�"Y` * Expires June 1,2023 [ Personally Known OR [ ] Produced Identification
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lBorried Thai Budget Notary servfcei Type of Identification: