1895 LIVE OAK LN - ERES21-0002 JS i , !r, ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
'� ERES21-0002
CITY OF ATLANTIC BEACH
x ISSUED: 1/5/2021
800 SEMINOLE ROAD
�°`; >r ATLANTIC BEACH, FL 32233 EXPIRES: 7/4/2021
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:
1895 LIVE OAK LN ELECTRICAL RESIDENTIAL ELECTRICAL- MAIN BREAKER $500.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
172020 1416 SELVA MARINA UNIT 12C
R/P
COMPANY: ADDRESS: CITY: STATE: ZIP:
ISLAND ELECTRIC OF THE JACKSONVILLE
PO BOX 50636 FL 32250
FIRST C BEACH
OWNER: ADDRESS: CITY: STATE: ZIP:
KUPPERMAN GREG 1895 LIVE OAK LN ATLANTIC BEACH FL 32233-4509
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT II\
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.
L SOF CONDITIONS
I
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 REPAIRS AND MISC 455-0000-322-1000 0 $35.00
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:$94.00
Issued Date: 1/5/2021 1 of 2
Electrical Permit Application **ALL INFORMATION
hs�-� pp
HIGHLIGHTED IN
is
City of Atlantic Beach Building Department GRAY IS REQUIRED.
800 Seminole Rd, Atlantic Beach, FL 32233 c Res l _ 0002
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:
JOB ADDRESS: 1805 L i Je cc Ln PROJECT VALUE $ 57-t). co
JEA INFORMATION REQUIRED ON ALL PERMITS: 203 AMPS 241)VOLTS I PHASE
El NEW SERVICE: 0 Overhead ❑Underground DUnderground up Pole
DResidential (Main)Service:
00-100 amps 0101-150amps 0151-200amps El amps #of Meters
❑Commercial (Main)Service:
❑0-100 amps 0101-150amps 0151-200amps 0 amps OCT Service amps
Conductor Type Size
DMulti-Family(Main) Service:
00-100 amps 0101-150amps [1151-200amps ❑ amps #of Unit Meters
El TEMPORARY POLE: amps
0 SERVICE UPGRADE: 0 amps OCT Service amps
❑ NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.):
0100 amps 0150amps 0200amps 0 amps OCT Service amps
❑ ADDITIONS, REMODELS, REPAIRS, BUILD-OUTS,ACCESSORY STRUCTURES, ETC:
Outlets/Switches: 0-30am ps 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:
lIl OTHER ELECTRICAL PROJECTS:
['Swimming Pool❑Sign ❑Smoke Detectors (Qty) ❑Transformers KVA ❑Motors HP
0 FIRE ALARM SYSTEM (Requires 3 sets of plans):
Qty volts/amps
NI REPAIRS/MISCELLANEOUS:
['Replace Burnt/Damaged Meter Can OSafety Inspection DPanel Change DOH to UG
►.ether: ' ►LCu e— loirO 1 6N1 akin r Q,ct o,i (sE, Lz, c.IL r,(1'I Yv►�+cVe-) 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.
Owner Name: V----c-"--PP- --ArC'1c k\ Phone Number: 43 - 7 f123
Electrical Company: ,5(C+-lrK*. Ea e G 4-i Office Phone: ZL-+ 0�S Fax:
Co.Address: 407 _51",.1.4 AVl AI City: COW, :Et_1(1 State: I� Zip: 3-22..S7)
License Holder: -3—c.:1/1 Vl.x1/1 2_EaP State Certification/Registration#: ''...:C.--/,3(...0 173(14
Notarized Signature of License Holder \jP_x,)►✓ K. —r
The foregoing instrument was acknowledged before me this 5 da a_ Ali P in the State of Florida, County of
5.( ;•�.raY.ey c, TONI G:NDLESPERGER ignature of Notary Public Ir�.J.
5.j=; ! •, MY COMMISSION#GG 353178
`"� EXPIRES:October 6,2023 [ 1 Personally Known OR [ ),Produced Identificati.'
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'•.,oFF�,, Bonded Thru Notary Public Underwriters Type of Identification: >L/