1753 Live Oak Ln ERES20-0255 Elec for PoolOWNER:ADDRESS:CITY:STATE:ZIP:
SCOTT JOSEPH M 1201 SEMINOLE RD ATLANTIC BEACH FL 32233
COMPANY:ADDRESS:CITY:STATE:ZIP:
HAZOURI ELECTRIC, INC.6142 Golden Oak Lane Keystone Heights FL 32656
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
172020 0186 SELVA MARINA UNIT 06
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
1753 LIVE OAK LN ELECTRICAL RESIDENTIAL ELECTRIC FOR POOL $985.00
FEES
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
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
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.
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.
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.
1 of 2Issued Date: 11/2/2020
PERMIT NUMBER
ERES20-0255
ISSUED: 11/2/2020
EXPIRES: 5/1/2021
ELECTRICAL RESIDENTIAL PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
2 of 2Issued Date: 11/2/2020
PERMIT NUMBER
ERES20-0255
ISSUED: 11/2/2020
EXPIRES: 5/1/2021
ELECTRICAL RESIDENTIAL PERMIT
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
DESCRIPTION ACCOUNT QTY PAID
PermitTRAK $99.00
ERES20-0255 Address: 1753 LIVE OAK LN APN: 172020 0186 $99.00
ELECTRICAL $95.00
ELECTRICAL BASE FEE 455-0000-322-1000 0 $55.00
ELEC SWIMMING POOLS 455-0000-322-1000 0 $40.00
STATE SURCHARGES $4.00
STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL FEES PAID BY RECEIPT: R14009 $99.00
Printed: Monday, November 2, 2020 3:43 PM
Date Paid: Monday, November 02, 2020
Paid By: HAZOURI ELECTRIC, INC.
Pay Method: CREDIT CARD 391751366
1 of 1
Cashier: CG
Cash Register Receipt
City of Atlantic Beach
Receipt Number
R14009
ER ES Z0 -- oz 55
1,...L,r" Electrical Permit Application ALL INFORMATION
HIGHLIGHTED IN
t 1`` City of Atlantic Beach Building Department GRAY IS REQUIRED.z i.
800 Seminole Rd, Atlantic Beach, FL 32233
t', Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: t () -°
C-) c.3
JOB ADDRESS: l 125-3 L t'(r 1)/4( 6-.->PROJECT VALUE$ 7$'
T
JEA INFORMATION REQUIRED ON ALL PERMITS: vgO7AMPS 1M-0VOLTS ( PHASE
I NEW SERVICE: o Overhead oUnderground 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 nCT Service amps
Conductor Type Size
Multi-Family(Main) Service:
u0-100 amps o101-150amps o151-200amps amps U of Unit Meters
TEMPORARY POLE: amps
SERVICE UPGRADE: amps oCT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES, ETC.):
100 amps 150amps 200amps amps CT Service amps
ADDITIONS, REMODELS, REPAIRS, BUILD-OUTS,ACCESSORY STRUCTURES, ETC:
Outlets/Switches: 0-30a m ps 31-100amps 101-200amps
Appliances: 0-30amps 31-100amps 101-200amps
A/C Circuits:0-60amps 61-100amps
Heat Circuits: It circuits @ kw
Number of Lighting Outlets, Including Fixtures:
n OTHER ELECTRICAL PROJECTS:
Swimming Pool oSign oSmoke Detectors Qty) oTransformers KVA Motors HP
I I FIRE ALARM SYSTEM (Requires 3 sets of plans):
Qty volts/amps
REPAIRS/MISCELLANEOUS:
Replace Burnt/Damaged Meter Can oSafety Inspection Panel Change DOH to UG
oOther:
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 ermit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of
construction.
OL,tr
E-- / c Y-7-.1-7/-3 Y(jOwnerName: !!!!"`` yC /
CT l 2-F ,,at-- Phone Number:
r
Electrical Company: 0 ' 0 l - "7Ct C Office Phone: 70Y-5-7/1-3 yKt, Fax:
Co.Address: (ji-1 L/60I 9.i-L( C4,....) City:j ft/'-State: /CC Zip: 3 zl/ O
License Holder: ?SC_.yIr-- c...-- State Certification/Registration#: C Ad 0 03 29
Notarized Signature of License Holder' ,rte -/
The foregoing instrument was acknowledged before me this day of Q c / ,20 Z`in the State of Florida,County of i(d1/4-/4-6--
SiArn
gnature of Notary Public `-'H0 R08ERTS Ilblic-State of Florida IissionkGG2119251YtersonallyKnownOR[ ] Produced Identification
Expires Aug 21,2022 ` Type of Identification:
h National Notary Assn.