1870 SEMINOLE RD ERES21-0111 ,,: '%w,' "a'' ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
J�: � tES21-0111
�'r,� ,e_. - CITY OF ATLANTIC BEACH
ISSUED: 4/28/2021
800 SEMINOLE ROAD
:bili' ATLANTIC BEACH, FL 32233 EXPIRES: 10/25/2021
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:
1870 SEMINOLE RD ELECTRICAL RESIDENTIAL REMODEL& UPGRADE $4000.00
SERVICE TO 200 AMP
TYPE OF REAL ESTATE ZONING: ' BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
172020 0520 SELVA MARINA UNIT 09
COMPANY: I ADDRESS: CITY: ` STATE:
WADE'S ELECTRIC SERVICE 760 Pleasure Bay Dr JACKSONVILLE FL 32225
OWNER: i ADDRESS: I CITY: I STATE: ZIP:
CHRISMAN STACEY 1870 SEMINOLE RD ATLANTIC BEACH FL 32233-5916
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT If\
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 l'
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 AIR CONDITIONING CIRCUITS 455-0000-322-1000 0 $5.00
ELEC APPLIANCES FIXED OR STATIONERY 455-0000-322-1000 0 $8.00
ELEC HEAT 455-0000-322-1000 0 $0.00
ELEC LIGHTING OUTLETS,INCLUDING FIXTURES 455 0000-322-1000 10 $6.00
ELEC SERVICE CHANGE 455-0000-322-1000 200 $50 00
ELECTRICAL BASE FEE 455-0000-322-1000 0 $55.00
Issued Date:4/28/2021 1 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 GR ES a - cj( t (
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: RE'c21 -LO go
JOB ADDRESS: / 7(J Sc.,11�,vL Ie gi,j0 PROJECT VALUE $ L c_-'C)
JEA INFORMATION REQUIRED ON ALL PERMITS: 2f AMPS 2-1/6' VOLTS / PHASE
NEW SERVICE: Overhead DUnderground ❑Underground up Pole
❑Residential (Main)Service:
❑0-100 amps -101-150amps o151-200amps ❑ amps #of Meters
Commercial (Main) Service:
❑0-100 amps E101-150amps o151-200amps ❑ amps ECT Service amps
Conductor Type Size
❑Multi-Family(Main)Service:
❑O-100 amps E101-150amps n151-200amps ❑ amps #of Unit Meters
TEMPORARY POLE: amps
Fr SERVICE UPGRADE: I < amps 1CT Service amps CA. aS I SO c-..M, fx.s
NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.):
E100 amps ❑150amps 200amps amps DCT Service amps
. 1 ADDITIONS, REMODELS, REPAIRS, BUILD-OUTS, ACCESSORY STRUCTURES, ETC:
Outlets/Switches: K--; 0-30amps 31-100amps 101-200amps
Appliances: 0-30amps 31-100amps 101-200amps
A/C Circuits: / 0-60amps 61-100amps
Heat Circuits: I # circuits @ kw
Number of Lighting Outlets, Including Fixtures: /0
LI OTHER ELECTRICAL PROJECTS:
Swimming Pool Sign iSmoke Detectors (Qty) ❑Transformers KVA ❑Motors HP
--1 FIRE ALARM SYSTEM (Requires 3 sets of plans):
Qty volts/amps
n REPAIRS/MISCELLANEOUS:
nReplace Burnt/Damaged Meter Can ❑Safety Inspection uPanel 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.
Owner Name: 13 CA.) QN , S+-ac / 1---/ S'11 63,2/ Phone Number:
f�t
Electrical Company: (�.e.5 L,[cam ^/iL 5*Jtiftk 7171/5—Office Phone: 6 C7 ) 3 Fax:
Co.Address: 76Co P 1ec SC/re_ I3A y 3 r -.'"e_. City: J2 - - ,)(e State: FL- Zip: 322-ZS
License Holder: jiccke. �e-TG�•+1�,1,.v/�'r� State Certification/Registration#:•
Notarized Signature of License Holder 1- a�c._ = '"
The foregoing instrument was acknowledged before me this 2—/day o ,202_tin the State of Florida,County of
Signature of Notary Public r `�
:7,T;7,::, TOM GINDLESPERGER
!• • ' MY COMMISSION#GG 353178 [ ] Personally Known OR[ ] Produced Identification
* EXPiRES:Oct-ter 6,2023 Type of Identification:
no' Bonded1'n�nNotary Public Underwriters