346 Seminole Rd ERES21-0171 2 Appliances rT rJ�` ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
A, CITY OF ATLANTIC BEACH ERES21-0171
800 SEMINOLE ROAD ISSUED: 7/16/2021
, , EXPIRES: 1/12/2022
,,'s� ATLANTIC BEACH. FL 32233
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:
346 SEMINOLE RD ELECTRICAL RESIDENTIAL 2 Appliances $500.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: NUMBER: I GROUP:
170430 0005 SALTAIR SEC 02
COMPANY: ADDRESS: CITY: j STATE: ZIP:
LORE ELECTRICAL PONTE VEDRA
210 N ROSCOE BLVD FL 32082
CONTRACTORS BEACH
OWNER: ADDRESS: CITY: STATE: ZIP:
BYRD ELIZABETH VIRGINIA 346 SEMINOLE RD ATLANTIC BEACH FL 32233-4145
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 APPLIANCES FIXED OR STATIONERY 455-0000-322-1000 0 $4.00
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:$63.00
Issued Date:7/16/2021 1 of 2
Electrical Permit Application **ALL INFORMATION
' "' "'�'�� �� HIGHLIGHTED IN
i
City of Atlantic Beach Building Department GRAY IS REQUIRED.
/1 800 Seminole Rd, Atlantic Beach, FL 32233
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#: FR C,5 2 f _0 1-7/
JOB ADDRESS: 3`-k /A,1018-- !'2 PROJECT VALUE $ ,S--cD
JEA INFORMATION REQUIRED ON ALL PERMITS: 2e-o AMPS 230 VOLTS i PHASE
P1 NEW SERVICE: ❑ Overhead ❑Underground ❑Underground up Pole
❑Residential (Main)Service:
❑0-100 amps o101-150amps o151-200amps ❑ amps #of Meters
❑Commercial (Main) Service:
❑0-100 amps o101-150amps o151-200amps ❑ amps ECT Service amps
Conductor Type Size
❑Multi-Family(Main)Service:
❑0-100 amps o101-150amps o151-200amps ❑ amps #of Unit Meters
TEMPORARY POLE: amps
SERVICE UPGRADE: ❑ amps DCT Service amps
] NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.):
100 amps 150amps 200amps amps CT Service amps
LI ADDITIONS, REMODELS, REPAIRS, BUILD-OUTS,ACCESSORY STRUCTURES, ETC:
Outlets/Switches: 0-30a m ps 31-100amps 101-200am ps
Appliances: L 0-30amps 31-100amps 101-200amps
A/C Circuits: 0-60amps 61-100am ps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
Li OTHER ELECTRICAL PROJECTS:
❑Swimming Pool ❑Sign ❑Smoke Detectors (Qty) ❑Transformers KVA ❑Motors HP
LI FIRE ALARM SYSTEM (Requires 3 sets of plans):
Qty volts/amps
] REPAIRS/MISCELLANEOUS:
❑Replace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change ❑OH to UG
❑Other: Updated l0/17/18
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. L'y,. (�
Owner Name: // r�-ts( n Phone Number:
Electrical Company: Lone- `� ✓-/f L4• Office Phone: 90(t- 2-73—/N 3 Fax:
Co.Address: Ito N. Y"`O S c-Oe IS[ iict, City: 0 ti 6 State: - Zip: 3 ZD&2_
License Holder: M (..iineT�lL• �� StateStCertification/Registration#: . 19 ( '�O �•
���Notarized Signature of License Holder ' ---)�V ""L
The foregoing instrument was acknowledged before me this day of �U 1,1 ,20 24,in the Stat of Florida,County of p II vAt
•<'�ye • CHRISTIAN GILES Signature of Notary Public
'/6' c / l%'/
f..: a. 'c,: MY COMMISSION#HH 117153
• gar EXPIRES:April 13,2025 [ ) Personally [
�,•.'�P� Known OR roduced Iden j�it;Lion
'•E.Fg�°'' Bonded?►wNotaryPubrcunderwriters Type of Identification: ) - P