1240 Seminole Rd ERES20-0054 New Elec Service %S`''` ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
�' CITY OF ATLANTIC BEACH ERES20-0054
" ISSUED: 2/25/2020
800 SEMINOLE ROAD
���''' �r V ATLANTIC BEACH. FL 32233 EXPIRES: 8/23/2020
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:
1240 SEMINOLE RD ELECTRICAL RESIDENTIAL NEW ELECTRIC SERVICE 400
AMPS $2800.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
171937 0005 SELVA MARINA UNIT 02
COMPANY: ADDRESS: CITY: STATE: ZIP:
TRI COUNTY ELECTRICAL 11637 E COLUMBIA PRK DR JACKSONVILLE FL 32258
OWNER: ADDRESS: CITY: STATE: ZIP:
NEIDHOLD SCOTT T 1627 BRICKELL AVE #2804 MIAMI FL 33129
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.
FEES
DESCRIPTION ACCOUNT QUANTITY PAID AMOUNT
ELEC NEW SINGLE FAMILY 455-0000-322-1000 400 $110.00
ELECTRICAL BASE FEE 455-0000-322-1000 0 $55.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.48
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $169.48
Issued Date: 2/25/2020 1 of 2
<:;:i' �\'' ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
" /�r-
(,-). �`�, ERES20-0054
CITY OF ATLANTIC BEACH
v 800 SEMINOLE ROAD ISSUED: 2/25/2020
�'"'0 EXPIRES: 8/23/2020
ATLANTIC BEACH. FL 32233
Issued Date: 2/25/2020 2 of 2
ALL
Electrical Permit Application
"`HIGHLIGHTEDI INFORMATION
Ji ' "' I'� IN
( ,,,� .1' City of Atlantic Beach Building Department GRAY IS REQUIRED.
`\ �j 800 Seminole Rd, Atlantic Beach, FL 32233 L R E-SzC)' OQ5�
'-, ``T''r Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT4: I G -0k) --
JOB ADDRESS: l--A 4 0 S-Q v- ..i)(,)1,e 1`2C.(tc( PROJECT VALUE $ ,,,406•0)
JEA INFORMATION REQUIRED ON ALL PERMITS: '"IL's AMPS'' LH-IVOLTS / PHASE
X'NEW SERVICE: 0 Overhead 'Underground ❑Underground up Pole
iliOlesidential (Main) Service:
00-100 amps 0101-150amps 0151-200amps % LIDO amps # of Meters / •
❑Commercial (Main)Service:
00-100 amps D101-150amps 0151-200amps ❑ amps OCT Service amps
Conductor Type Size
❑Multi-Family(Main)Service:
❑0-100 amps D101-150amps 1:3151-200amps ❑ amps #of Unit Meters
TEMPORARY POLE: amps
I I SERVICE UPGRADE: 0 amps OCT Service amps
NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.):
0100 amps 0150amps 0200amps 0 amps ❑CT Service amps
Li ADDITIONS, REMODELS, REPAIRS, BUILD-OUTS, ACCESSORY STRUCTURES, ETC:
Outlets/Switches: 0-30amps 31-100amps 101-200a mps
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) OTransformers KVA ❑Motors HP
FIRE ALARM SYSTEM (Requires 3 sets of plans):
Qty volts/amps
REPAIRS/MISCELLANEOUS:
Replace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change 00H to UG
Updated 10/11/18
❑ether:
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. n/ / ` v. ,,D,-1 c)�1
Owner Name: / t' �, o 1(Y I , V - ,4_,2 Hu u.,2)
Phone Number: 90 v—,5-9/-0 c/
Electrical Company: Tri County Ele rical Contractors, Inc. Office Phone: (994)280.9889 Fax:(904)260.9688
Co.Address: 11637 East Columbia Park Drive City: Jacksonville State: FL Zip: 32258
License Holder: Kevin L. Weirs to Certification/Registration h: EC13005421
Notarized Signature of License Holder �� -
The foregoing instrument vy s ck owledged before me this 19 day I=t.4• ,. 2D3Q in the State of Florida, County of -b UVq�
ytR;(':;: TAMMY PALL � Signature of Notary Public 0� x1 �. PC-A.- -e
_ �.` =- Notary Public -State of Florida Il
;l• r •�; Commission # FF 995425personally Known OR( ] Produced Identification
=,,9�FIo�, My Comm.Expires Jul 6,2020 Type of Identification:
Bonded through National Notary Assn
r � Cash Register Receipt Receipt Number
r^ -!: City of Atlantic Beach R11819
0.3 9%
DESCRIPTION I ACCOUNT QTY I PAID
PermitTRAK $169.48
ERES20-0054 Address: 1240 SEMINOLE RD APN: 171937 0005 $169.48
ELECTRICAL $165.00
ELECTRICAL BASE FEE 455-0000-322-1000 I 0 $55.00
ELEC NEW SINGLE FAMILY 455-0000-322-1000 400 $110.00
STATE SURCHARGES $4.48
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.48
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL FEES PAID BY RECEIPT: R11819 $169.48
Date Paid: Tuesday, February 25, 2020
Paid By: TRI COUNTY ELECTRICAL
Cashier: FJ
Pay Method: CREDIT CARD 3
Printed:Tuesday, February 25, 2020 10:06 AM 1 of 1 i