281 Pine St ERES19-0356 Panel Change J,'?#rs ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
'-
` CITY OF ATLANTIC BEACH ERES19-0356
��, V 800 SEMINOLE ROAD ISSUED: 12/19/2019
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ATLANTIC BEACH. FL 32233 EXPIRES: 6/16/2020
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:
281 PINE ST ELECTRICAL RESIDENTIAL 200 amps/240 volts/first $500.00
phase - panel change
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
170560 0050 SALTAIR SEC 03
COMPANY: ADDRESS: CITY: STATE: ZIP:
INTEGRITY FIRST ELECTRIC JACKSONVILLE
COMPANY 920 8TH AVENUE S #D BEACH FL 32250
OWNER: ADDRESS: CITY: STATE: ZIP:
LILES HALL B III 281 PINE ST 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.
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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: 12/19/2019 1 of 2
ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
f- CITY OF ATLANTIC BEACH ERES19-0356
800 SEMINOLE ROAD ISSUED: 12/19/2019
ATLANTIC BEACH. FL 32233 EXPIRES: 6/16/2020
Issued Date: 12/19/2019 2 of 2
:-- , Electrical Permit Application **ALL INFORMATION
��ri pp:OW HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
\` % 800 Seminole Rd, Atlantic Beach, FL 32233
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Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: Wpim) «—d 6
JOB ADDRESS: 281 PINE STREET PROJECT VALUE$$ 500.00
JEA INFORMATION REQUIRED ON ALL PERMITS: 200 AMPS 240 VOLTS 1 PHASE
n NEW SERVICE: 0 Overhead ❑Underground Underground up Pole
otesidential (Main)Service:
00400 amps 0101-150amps ❑151-200amps 0 amps #of Meters 1
❑Commercial (Main)Service:
00-100 amps 0101-150amps ❑151-200amps 0 amps OCT Service amps
Conductor Type Size
❑Multi-Family(Main)Service:
❑0-100 amps 0101-150amps ❑151-200amps 0 amps #of Unit Meters
11 TEMPORARY POLE: amps
El SERVICE UPGRADE: ❑ amps OCT Service amps
El NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.):
0100 amps 0150amps 0200amps 0 amps OCT Service amps
❑ ADDITIONS, REMODELS, REPAIRS, BUILD-OUTS, ACCESSORY STRUCTURES, ETC:
Outlets/Switches: 0-30am ps 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 DSmoke Detectors (Qty) ❑transformers KVA ❑Motors HP
n FIRE ALARM SYSTEM (Requires 3 sets of plans):
Qty volts/amps
I iJ REPAIRS/MISCELLANEOUS:
['Replace Burnt/Damaged Meter Can ❑Safety Inspection DPanel Change ❑OH to UG
❑7ther: 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: WALTER HAYNES Phone Number: (904)246-6613
Electrical Company: INTEGRITY FIRST ELECTRIC Office Phone: (904)246-8613 Fax:
920D 8TH AVENUE S. City:Address: SAX BEACH State: FL Zip: 32250
License Holder: WALTER HAYNES State Certification/Registration#: FC13003883
Notarized Signature of License Holder
The foregoing instrument was acknowledged before me this !j1,-day off LfJili3l2,20 /1 in the State of Florida,County of _NU VJIY
. } ",:••. SUZANNE THOMPSON Signature of Notary Public--Lt,7(t 'cok.f5 ,s_`—
• a , Commission#GG 204791 J
•;: :' ExpiresApri18,2022 [(,Personally Known OR[ ] Produced Identification
Boded Thu Troy Fain Insurance 800•38S-7019 Type of Identification: