1985 Brista De Mar Cir ERES21-0174 Panel Change ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
ttittir r) CITY OF ATLANTIC BEACH
ERES21-0174
800 SEMINOLE ROAD ISSUED: 7/21/2021
- I ATLANTIC BEACH. FL 32233 EXPIRES: 1/17/2022
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:
1985 BRISTA DE MAR CIR ELECTRICAL RESIDENTIAL PANEL CHANGE $750.00
TYPE OF REAL ESTATE ZONING: BUILDING USE SUBDIVISION:
CONSTRUCTION: I NUMBER: GROUP:
169506 1676 SELVA NORTE UNIT 02
COMPANY: ADDRESS: CITY: STATE: ZIP'•
PHASE ONE ELECTRIC LLC 2076 CORONA CT JACKSONVILLE FL 32224
OWNER: ADDRESS: CITY: STATE: ZIP:
SHEKLIN MICHAEL A 1985 BRISTA DE MAR CIR ATLANTIC BEACH FL 32233-4525
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.
,.IST 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 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:7/21/2021 1 of 2
i'`IN. ELECTRICAL RESIDENTIAL PERMIT PERMIT NUMBER
'1 ERES21-0174
,�
CITY OF ATLANTIC BEACH
-6V/01 800 SEMINOLE ROAD ISSUED: 7/21/2021
P o'i 0 ATLANTIC BEACH. FL 32233 EXPIRES: 1/17/2022
Issued Date:7/21/2021 2 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 ERESZ i _ 0174-
Phone: (904) 247-5826 Email: Building-Dept@coab.us PERMIT#:
JOB ADDRESS: 'V1 ) t \3\-3\ ' IM - C r PROJECT VALUE $ T.. �.�'
JEA INFORMATION REQUIRED ON ALL PERMITS: AMPS21.1inVOLTS 1 PHASE
1 I NEW SERVICE: u Overhead ❑Underground ❑Underground up Pole
❑Residential (Main) Service:
❑0-100 amps o101-150amps E151-200amps ❑ amps #of Meters
❑Commercial (Main) Service:
❑0-100 amps o101-150amps D151-200amps ❑ amps ❑CT Service amps
Conductor Type Size
LiMulti-Family(Main)Service:
❑O-100 amps o101-150amps D151-200amps ❑ amps #of Unit Meters
TEMPORARY POLE: amps
SERVICE UPGRADE: amps CT Service amps
NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.):
❑100 amps ❑150amps .200amps i I amps DCT Service amps
1 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:
Li OTHER ELECTRICAL PROJECTS:
DSwimming Pool FSign ❑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 nSafety Inspection ,'anel 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. Thep emit does not give authority to violate the provisions of any othr state or local law regulation construction or th e o an
Oof7 14
construction.
Owner Namg:%7a,,s,...k-Ame* - .•n IL & ' t !\ Phone�N^umber: dna' (13
Electrical Company: - ^C ma ESRC_ Office Phone: (1'9 2 G� Fax: y�
Co.Address: 1:6(0 JCyf n-4 City: Stater— Zip: �.[23S
License Holder: CL,-,r N.t•Je State Certification/Registration#: t.�__VJC'�' .S�
Notarized Signature of License Holder .. ���_ v
am
The foregoing instrument was acknowledged be 4111211Mrirrioa, (n th State of Florida,County of
Signature of Notary Public •
: .....?.q.;•.,, TONI GINDLESPERGER
cMYCOMMISSION#GG 353178 ......1...1-Personally Known OR[ ] Produced Identification
'' Type of Identification:
.. .•o; EXPIRES:October 6,2023
•,•°",n;°¢'. Bonded Thru Notary Public Undeiwrtters