1842 Hickory Ln ERES21-0091 24 Fixtures, 1 Outlet/Switch % 141 ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
J '
t' ERES21-0091
"' CITY OF ATLANTIC BEACH�'�°- �� ISSUED: 4/8/2021
800 SEMINOLE ROAD
�`Di4��r ATLANTIC BEACH, FL 32233 EXPIRES: 10/5/2021
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:
1842 HICKORY LN ELECTRICAL RESIDENTIAL 24 Fixtures, 1 Outlet/Switch $3500.00
TYPE OF REAL ESTATE ZONING: I BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
172020 1452 SELVA MARINA UNIT
12C R/P
COMPANY: ADDRESS: CITY: STATE: i' ZIP:
CONTE ELECTRIC 8474 HARROW CT JACKSONVILLE FL 32217
COMPANY, INC
OWNER: ADDRESS: CITY: STATE: ZIP:
ROSA DOUGLAS W ET AL 12527 TENNY CRAGS RD COLORADO SPRINGS CO 80921
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 LIGHTING OUTLETS,INCLUDING FIXTURES 455-0000-322-1000 24 $14.40
ELEC SWITCH AND RECEPTACLE OUTLETS 455-0000-322-1000 0 $0.60
ELECTRICAL BASE FEE 455-0000-322-1000 0 $55.00
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STATE DBPR SURCHARGE 455-0000-208-0700 0 $2.00
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STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
Issued Date:4/8/2021 1 of 2
%' LA' ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
r Rs ERES21-0091
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
.4 `' ISSUED: 4/8/2021
'i0 ATLANTIC BEACH, FL 32233 EXPIRES: 10/5/2021
I
TOTAL:$74.00
Issued Date:4/8/2021 2 of 2
Electrical Permit Application **ALL INFORMATION
�� HIGHLIGHTED IN
City of Atlantic Beach Building Department GRAY IS REQUIRED.
r , ,, 800 Seminole Rd, Atlantic Beach, FL 32233 D
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: t " S2I1
-0091
JOB ADDRESS: \ N t C. c K- - PROJECT VALUE $ 3 5 0 0 •0
JEA INFORMATION REQUIRED ON ALL PERMITS: A AMPS).`Iv VOLTS \ PHASE
NEW SERVICE: Overhead ❑Underground ❑Underground up Pole
❑Residential (Main)Service:
F0-100 amps n101-150amps o151-200amps ❑ amps #of Meters
❑Commercial (Main) Service:
❑0-100 amps o101-150amps D151-200amps ❑ amps ❑CT Service amps
Conductor Type Size
❑Multi-Family(Main) Service:
0400 amps 101-150amps o151-200amps ❑ amps #of Unit Meters
TEMPORARY POLE: amps
❑ SERVICE UPGRADE: amps r CT Service amps
❑ NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.):
❑100 amps ❑150amps ❑200amps u amps [ACT Service amps
ADDITIONS, REMODELS, REPAIRS, BUILD-OUTS, ACCESSORY STRUCTURES, ETC:
Outlets/Switches: \ 0-30amps 31-100amps 101-200amps
Appliances: 0-30a nips 31-100amps 101-200amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures: XL\
I 1 OTHER ELECTRICAL PROJECTS:
❑Swimming Pool nSign ❑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 ❑Panel Change DOH 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.
- 2—\.1 - \\,o3
OwnerN
Name: �ovr R 0--)c‘_ Phone Number: -1S1
Electrical Company: C 0:AA s T nc . Office Phone: \Oy -1_31 --I Z-o Fax:c1 O -13')-L f
Co.Address: <:6,\---1'- N c,r r o -� (4 . City: ��c.1C S 1
c,c .�X11 c State: Ft• Zip: ' -)-\
License Holder: E_` �c"c\ C o -\ e_ State Certification/Registration#: EC - 13 007.oS 1
Notarized Signature of License Holder 1
•
The fore oin instrument was acknowledged before me this 6day o ��r( et 4 tin the S ate of Florida,County of
! .rnYP� TONI GINDLESPERGER Signature of Notary Public 14 ,'
:,k, MY COMMISSION#GG 353178
EXPIRES:October 6,2023 [ ] Personally Known OR[ ] Produced Identification
`'otF° Bonded ThruNotary Public Underwrlters Type of Identification: