353-355 ERES19-0111 Elec for Pool IF
ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH ERE519-0111
800 SEMINOLE ROAD ISSUED: 4/10/2019
-v ATLANTIC BEACH. FL 32233 EXPIRES: 10/7/2019
CODE,MUST CALL INSPECTION PHONE LINE (904) 247-5814 BY 4 PM FOR NEXT DAY INSPECTION.
AND CITY OF • • 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 • rr • DESCRIPTION:
353 355 2ND ST ELECTRICAL RESIDENTIAL 200 amps/240 volts/single- $0.00
phase-elec for pool
TYPE • BUILDINGUSE
• SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
169786 0000 ATLANTIC BEACH
COMPANY: ADDRESS:
HAZOURI ELECTRIC, INC. P O BOX 56559 JACKSONVILLE FL 32241
• ADDRESS: CITY: STATE: ZIP:
JOHNSONJOANN 181 PROCTORS PURCHASE RD HARTLY DE 19953
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 • r
Roll off container company must be on City approved list. Container cannot be placed on City right-of-way.
DESCRIPTION ACCOUNT QUANTITY PAIDAMOUNT
ELEC SWIMMING POOLS 4550000322-1000 0 $4000
ELECTRICAL BASE FEE 455-0000322-1000 0 $55.00
STATE OBPR SURCHARGE 455-OOW 208-0]00 0 $200
STATE DCA SURCHARGE 455 WEEK)-208-0600 0 SERO
TOTAL:$99.00
Issued Date:4/10/2019 1 of 2
ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
CITY OF ATLANTIC BEACH ERES19-0111
800 SEMINOLE ROAD ISSUED: 4/10/2019
` ATLANTIC BEACH. FL 32233 EXPIRES: 10/7/2019
Issued Date:4/10/2019 2 of 2
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach,FL 32233
Ph(904)247-5826 Fax(904)247-5845 e q-t S i `I'
JOB ADDRESS: 3S"3 Z 5Z;-'e,7 PERMIT# /9- fJQ�
JEA INFORMATION REQUIRED ON ALL PERMITS —Loa AMPS oo?rr (-VOLTS _�PHASE
VALUE OF WORK$��
NEW SERVICE ❑ Overhead ❑ Underground ❑1 Underground up Pole
'..Residential(Main)Service
0-100 amps - ❑101-150amps ❑151-200amps ❑ amps #of Meters
-(Commercial(Maio)Service
110-100 amps 0101-150amps ❑151-200amps ❑ amps ❑CT Service amps
Conductor Type Size
[]Multi-Family(Main)Service
DO-100amps ❑101-150amps ❑151-200amps ❑ amps #of Unit Meters
❑Temporary Pole amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps ❑150amps I j200amps ❑ 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:
OTIC$ELECTRICAL PROJECTS
Swimming Pool [] Sign ❑Smoke Detectors_Qty ❑Transformers KVA ❑Motom hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
❑Replace Burrt/Damaged Meter Can Il Safety Inspection Panel Change ❑OHto UG
❑Other.
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 then I have
read this application and know the same to be true and warel. 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.
Property Owners Name :TD-4s Phone Number
Electrical Company /t ZDv� �i-'C .-i Office Phone vY ax
Co.Address: t City State-Zip
License Holder(Print): State C 'fication/Registmtion#
Notarized Signature of License Holder
CHO ROBERTSSworn and subscribed before me of lJ 20 l
f '•, Notary Public-State of Fbrida
Sammission#GG 111919
a9 Cousin.Upkes Aag tl.mu Signature of Notary Public
Bonbetl through National Notary Assn.
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