1175 Seminole rd ERES20-0069 Pool Elec ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH ERES20-0069
� / 800 SEMINOLE ROAD ISSUED: 3/9/2020
ATLANTIC BEACH. FL 32233 EXPIRES: 9/5/2020
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:
1175 SEMINOLE RD ELECTRICAL RESIDENTIAL POOL ELECTRIC $985.00
TYPE OF REAL ESTATE BUILDING USE
ZONING: I SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
171890 0000 SELVA MARINA UNIT 01
COMPANY: ADDRESS: CITY: STATE: ZIP:
HAZOURI ELECTRIC, INC. 6142 Golden Oak Lane Keystone Heights FL 32656
OWNER: ADDRESS: CITY: STATE: ZIP:
MCKIMM ROBERT III 1175 SEMINOLE RD 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 SWIMMING POOLS 455-0000-322-1000 0 $40.00
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:$99.00
Issued Date:3/9/2020 1 of 2
rS''''`' ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER 1
f.r cr CITY OF ATLANTIC BEACH ERES20-0069
800 SEMINOLE ROAD
ISSUED: 3/9/2020
`'
� 'ij�� y ATLANTIC BEACH. FL 32233 EXPIRES: 9/5/2020
1
Issued Date: 3/9/2020 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 a: kL,s20--006
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:_
JOB ADDRESS: 1/ J e iv) i All`/C AIL.% PROJECT VALUE $ 7! S
JEA INFORMATION REQUIRED ON ALL PERMITS: AMPS VOLTS PHASE
NEW SERVICE: , i Overhead Underground ❑Underground up Pole
uResidential (Main) Service:
❑0-100 amps 101-150amps o151-200amps ❑ amps #of Meters
❑Commercial (Main) Service:
❑0-100 amps D101-150amps o151-200amps ❑ amps ❑CT Service amps
Conductor Type Size
❑Multi-Family(Main)Service:
❑0-100 amps o101-150amps o151-200amps ❑ amps #of Unit Meters
TEMPORARY POLE: amps
I I SERVICE UPGRADE: amps iCT Service amps
NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.):
100 amps 150amps 200amps 1 amps ❑CT Service amps
ADDITIONS, REMODELS, REPAIRS, BUILD-OUTS,ACCESSORY STRUCTURES, ETC:
Outlets/Switches: 0-30amps 3 1-100amps 101-200amps
Appliances: 0-30amps 3 1-100amps 101-200amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
I 1 OTHER ELECTRICAL PROJECTS:
Swimming Pool oSign ❑Smoke Detectors (Qty) ❑Transformers KVA ❑Motors HP
FIRE ALARM SYSTEM (Requires 3 sets of plans):
Qty volts/amps
REPAIRS/MISCELLANEOUS:
l;Replace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change DOH to UG
Other: 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. sq/I `
Owner Name: /,1 C,ll, tY.. Phone Number:n71/7
/, L/2 2- /)/c)
Electrical Company: /-i4 7,v c...3.., t "--;76,-.7---p•--7-1t "--;76,-.7---p•--7-1 ..�1 Y e c Office Phone: 3 J Y/ Fax:
Co.Address: (C/VZ �,'e� .t( City: /�s�c,--.c_ State: Zip:
License Holder: State CertificafIon/Registration#: ,4 Jc _) )7
Notarized Signature of License Holder- 1
The foregoing instr .. wledged before me this day aOribkS'' t : State of Florida,County of DU VQ_(
�= � �: Al
, ,.,, TONIC\--- PGG353178 Signature of Notary Publ ___• ��
,o,;y.,
``' 6''Q 0 COMMISSION 2023
! EXPIRES:October 6, tars
,„.;..,i Lol1�e�NNotary Public
rsonally Known OR[ ] Produced Identification
Type of Identification: