1969 W Sevilla Blvd ERES20-0046 Remodel } ''''- e ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
10Ahs . ,J ERES20-0046
CITY OF ATLANTIC BEACH
15° "� ISSUED: 2/21/2020
v F;,� 800 SEMINOLE ROAD EXPIRES: 8/19/2020
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:
1969 W SEVILLA BLVD ELECTRICAL RESIDENTIAL ELECTRIC- REMODEL $500.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
169462 0370 SEVILLA GARDENS UNIT
02
COMPANY: ADDRESS: CITY: STATE: ZIP:
SEASIDE ELECTRICAL 12381 APPLE LEAF DR JACKSONVILLE FL 32224
CONTRACTORS
OWNER: ADDRESS: CITY: STATE: ZIP:
KOSUT JANETTE ET AL 1969 SEVILLA BLVD W ATLANTIC BEACH FL 32233-4578
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:2/21/2020 1 of 2
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'' ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
ERES20-0046
CITY OF ATLANTIC BEACH ISSUED: 2/21/2020
`r.:JO/ 800 SEMINOLE ROAD EXPIRES: 8/19/2020
ATLANTIC BEACH, FL 32233
Issued Date:2/21/2020 2 of 2
Electrical Permit Application **ALL INFORMATION
HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 `004
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:PF-CA 2D °&Y--),
JOB ADDRESS: `96V $ ✓�~�(m i�/,/c/- PROJECT VALUE $
JEA INFORMATION REQUIRED ON ALL PERMITS: 7?)(' AMPS Z'R VOLTS / PHASE
NEW SERVICE: ❑ Overhead ❑Underground ❑Underground up Pole
❑Residential (Main)Service:
❑O-100 amps o101-150amps o151-200amps ❑ amps #of Meters
❑Commercial (Main)Service:
❑0-100 amps o101-150amps o151-200amps ❑ amps ECT Service amps
Conductor Type Size
❑Multi-Family(Main)Service:
❑O-100 amps o101-150amps o151-200amps ❑ amps #of Unit Meters
Li TEMPORARY POLE: amps
I I SERVICE UPGRADE: amps ❑CT Service amps
NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.):
n100 amps n150amps ❑200amps I Co amps ❑CT 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: I
OTHER ELECTRICAL PROJECTS:
nSwimming Pool uSign tSmoke Detectors (Qty) ❑Transformers KVA ❑Motors HP
FIRE ALARM SYSTEM (Requires 3 sets of plans):
Qty volts/amps _
REPAIRS/MISCELLANEOUS:
uReplace Burnt/D maged Meter Can ❑Safety Inspection ❑P/anel Change DOH to UG
tether: A(oc.ni*e i,)(41Ae;t..- Qitye+c 4Z) end4.1 /Lain. Updated10/17/18
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 authorit to violate the provisions of any other state or local law regulation construction or the performance of
construction. ,--- �v/
Owner Name: .J t"-'<_ T�SLA. n / Phone Number:
Electrical Company:5 i9crc(4 Cf'.c�/❑cse,-( ( AnT. Zc . Office Phone: dtc.Y " 65 5S— Fax:
Co.Address: /2-06 W3 /A4-,...4 #3#'...J 23.5 City: 7,rrc-7,e -•-16•- State: rL Zip: 722"l
License Holder: (7,A/Lk State Certification/Registration#: a72-17° 13S'/ 8
Notarized Signature of License Holder
The foregoing instrument was acknowledged before me thisJay 1 A 207r the Stat- of Florida,County of
? nature of Notary Publ 9
: re.'"••. TONIGINDLESPERGER
MY COMMISSION#GG 353178 [ Personally I ]
r•. Known OR Produced Identificati•
. �•o`. EXPIRES:October 6,2023 Type of Identification: CD;
a L.--
•EOF F`-?Q'' Bonded Thru Notary Puh'Ic Undernriters
_].1rRVVM{t A~.17 _