320 PLAZA ERES21-0123 i''''�'% ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
' t CITY OF ATLANTIC BEACH ERES21-0123
ISSUED: 5/19/2021
800 SEMINOLE ROAD
'''toluE ATLANTIC BEACH. FL 32233 EXPIRES: 11/15/2021
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:
320 PLAZA ELECTRICAL RESIDENTIAL Elec for KITCHEN REMODEL $1500.00
TYPE OF REAL ESTATE I BUILDING USE
ZONING: SUBDIVISION:
CONSTRUCTION: NUMBER: GROUP:
169958 0000 ATLANTIC BEACH
COMPANY: ADDRESS: CITY: STATE: ZIP:
SEASIDE ELECTRICAL 12620-3 Beach Blvd #235 JACKSONVILLE FL 32246
CONTRACTORS
OWNER: ADDRESS: ) CITY: i STATE: ZIP:
JEWELS WILLIAM C 320 PLAZA ST ATLANTIC BEACH FL 32233-5442
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 8 $4.80
ELEC SWITCH AND RECEPTACLE OUTLETS 455-0000-322-1000 0 $4.80
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:$68.60
Issued Date:5/19/2021 1 of 2
Electrical Permit Application **ALL INFORMATION
i�'� ����- - HIGHLIGHTED IN
F:
City of Atlantic Beach Building Department GRAY IS REQUIRED.
/i 800 Seminole Rd, Atlantic Beach, FL 32233/ —7
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:g<- C S i 'D)2e
JOB ADDRESS: 3 Z 0 ✓ // 2. ' PROJECT VALUE $ /; "a-"c' • `-)"
JEA INFORMATION REQUIRED ON ALL PERMITS: 2c-%" AMPS ?-1C VOLTS I PHASE
NEW SERVICE: Overhead uUnderground ❑Underground up Pole
❑Residential (Main) Service:
0-100 amps 101-150amps E151-200amps ❑ amps #of Meters
❑Commercial (Main) Service:
--0-100 amps E101-150amps n151-200amps ❑ amps ❑CT Service amps
Conductor Type Size
Multi-Family(Main)Service:
❑0-100 amps ❑101-150amps o151-200amps ❑ amps #of Unit Meters
n TEMPORARY POLE: amps
SERVICE UPGRADE: ❑ amps CT Service amps
NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.):
100 amps _ 150amps 200amps amps ECT Service amps
ADDITIONS, REMODELS, REPAIRS, BUILD-OUTS, ACCESSORY STRUCTURES, ETC:
Outlets/Switches: 8 0-30amps 31-100amps 101-200amps
Appliances: 0-30amps 31-100amps 101-200am ps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures: g
OTHER ELECTRICAL PROJECTS:
riSwimming Pool r Sign ❑Smoke Detectors (Qty) ❑Transformers KVA ❑Motors HP
FIRE ALARM SYSTEM (Requires 3 sets of plans):
Qty volts/amps
REPAIRS/MISCELLANEOUS:
nReplace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change ❑OH to UG
Other: Updated to/v/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: /� [ Phone Number:
Electrical Company: Se-. ,e—i--e. &/ ( - 1 W,t 1 Office Phone: 5.0A- — C/ ( "0C 3� Fax:
Co.Address: / 26 20 " & r-cin. 13(J i,.-??s--- City: ) 4-l ark v L 1 4 State: ("F— Zip: ,1/2.2 y6
����License Holder: 7C rrss % ) State •rti ,n/Regi ation#: L R 13 0 I s---/ G
Notarized Signature of License Holder ® / 7" --___,,,,,
The foregoing instrument was acknowledged before me this 1&) day of hi y ,20 2.1 , in the State
off Florida,County of
'` CHRISTIAN GILES Signature of NotaryPublic
ii.,i. MY COMMISSION#HH 117153
PersonallyKnown OR ro.
� + r'• EXPIR6S:April13,2025 [ � (� �uc� Idel7,tifilcation
`I '`•::',"°j Bonded ThruNotary Public UndorwrIters Type of Identification: I tJI-