108 Seminole Rd ERES20-0064 5 Fixtures, 1 App �rsv''`1% ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
,:-.) ,a� � ERES20-0064
� .: CITY OF ATLANTIC BEACH
,� ISSUED: 3/4/2020
800 SEMINOLE ROAD
`-!1'2 yr ATLANTIC BEACH. FL 32233 EXPIRES: 8/31/2020
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:
108 SEMINOLE RD ELECTRICAL RESIDENTIAL ELECTRIC REMODEL 5 $1500.00
FIXTURES & 1 APPLIANCE
TYPE OF : REAL ESTATEBUILDING USE I
ZONING: SUBDIVISION:
CONSTRUCTION: I NUMBER: i GROUP:
170590 0140 SALTAIR SEC 01
COMPANY: ADDRESS: CITY: STATE: ZIP:
PHASE ONE ELECTRIC LLC 2076 CORONA CT JACKSONVILLE FL 32224
OWNER: I ADDRESS: CITY: I STATE: ZIP:
RODNEY AND LINDA 1349 GOLDENROD HILLSBORO KS 67063
PETERS REVOCABLE TRUST
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 APPLIANCES FIXED OR STATIONERY 455-0000-322-1000 0 $2.00
ELEC LIGHTING OUTLETS,INCLUDING FIXTURES 455-0000-322-1000 5 $3.00
f
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
Issued Date: 3/4/2020 1 of 2
ELECTRICAL RESIDENTIAL PERMIT
r PERMIT NUMBER
CITY OF ATLANTIC BEACH ERES20-0064
ov x
800 SEMINOLE ROAD ISSUED: 3/4/2020
-,it 9',' EXPIRES: 8/31/2020
ATLANTIC BEACH, FL 32233
TOTAL:$64.00
Issued Date: 3/4/2020 2 of 2
rlLi:riy, Electrical Permit Application **ALL INFORMATION
HIGHLIGHTED IN
' City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 RE -Ce(O�{'
\�`' rl
� Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: f�€Sc;0 — O •91
JOB ADDRESS: I oc4 Ge_AA.nOk K cx2-Ct PROJECT VALUE$ )SOO
JEA INFORMATION REQUIRED ON ALL PERMITS: ISO AMPS I 0)0 VOLTS / PHASE
NEW SERVICE: ❑ Overhead ['Underground ❑Underground up Pole
❑Residential(Main)Service:
❑0-100 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:
❑0-100 amps o101-150amps o151-200amps ❑ amps #of Unit Meters
TEMPORARY POLE: amps
SERVICE UPGRADE: n amps nCT Service amps
I I NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.):
0100 amps ❑150amps ❑200amps ❑ amps ECT Service amps
f�I ADDITIONS, REMODELS, REPAIRS, BUILD-OUTS,ACCESSORY STRUCTURES, ETC:
Outlets/Switches: S 0-30amps 31-100am ps 101-200am 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:
OTHER ELECTRICAL PROJECTS:
❑Swimming Pool ❑Sign ❑Smoke Detectors (Qty) ❑Transformers KVA ❑Motors HP
FIRE ALARM SYSTEM (Requires 3 sets of plans):
Qty volts/amps
REPAIRS/MISCELLANEOUS:
❑Replace Burnt/Damaged Meter Can ['Safety Inspection DPanel Change nOH to UG
nOther: 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. (� / Ci bit' [i-a 3 6,qri
Owner Name: o&Aty P�*e5S Phone Number: '1 V Q
Electrical Company: -K)S'e 0n c.. C (Q Orflci I L(, Office Phone: (1Q 7L _- 3 0' Rc)(3.3 Fax:
Co.Address: c7 O7(0 Lar o4c C- City: T/ A State: r(, Zip: L7-1---11/2
License Holder: 4/ C , a i u� State Certifici.n/Registration It: [,(40100s,E?,K
Notarized Signature of License Holder AlWir 1-Pr. i
The foregoing instrument was acknowledged before me this 'day . IL.**ill
o the State of Florida,County of
signature of Notary Pub AIA-
. :°k TONI GINDLESPERGER
MY COMMISSION#GG 353178 f � Personally I
`�' Known OR Produced ldentificatio
� oP= EXPIRES:October 6,2023 Type of Identification:
.,,of n,, . Bonded Thru Notary Public Underwriters '
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