1221 MAYPORT RD ELPP21-0051s-ANr Electrical Permit Application ALL INFORMATION
HIGHLIGHTED INr/ 41" n:t City of Atlantic Beach Building Department GRAY IS REQUIRED.
Iir 800 Seminole Rd, Atlantic Beach, FL 32233
WI 0-Phone: (904)
4)
247-5826 Email: Building-Dept@coab.us PERMIT#: C i-LP 005 (
JOB ADDRESS: MAI p&e." PROJECT VALUE $ (S-67)•
IZGI
JEA INFORMATION REQUIRED ON ALL PERMITS: 701) AMPS 2J-Fo VOLTS I PHASE
NEW SERVICE: 0 Overhead Underground Underground up Pole 7 se("v Le.e-L
I:Residential (Main)Service:
0-100 amps 101-150amps 1:1151-200amps 0 amps of Meters
Commercial(Main)Service:
O0-100 amps 0101-150amps 0151-200amps 0 amps OCT Service amps
Conductor Type Size
OMulti-Family(Main)Service:
D3-100 amps 0101-150amps 0151-200amps 0 amps of Unit Meters
TEMPORARY POLE: amps
n
t-4SERVICEUPGRADE: ID amps CT Service amps
G I r `C
l('
ro.Ctl.1 ,A-a I'e-L_,
El NEWNEW FEEDER (ADDITIONS,ACCESSORY STRUCTURES, ETC.): N.i c.---2..04-- o•4
0100 amps 0150amps 0200amps 0 amps OCT Service amps
Z z J yJ I z /
ADDITIONS, REMODELS, REPAIRS, BUILD-OUTS,ACCESSORY STRUCTURES, ETC:tVI I LE_
Outlets/Switches: 0-30amps 31-100amps 101-200amps gad-re_s-sAppliances: 0-30amps 31-100amps 101-200amps
k
1)4A/C Circuits:0-60amps 61-100amps
Heat Circuits: circuits @ kw o r k-C_C_ o n
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS:
DSwimming Pool['Sign Smoke Detectors Qty) ['Transformers KVA ['Motors HP
FIRE ALARM SYSTEM (Requires 3 sets of plans):
CIty volts/amps
1-7 REPAIRS/MISCELLANEOUS: Fit".
5.eplace Burnt/Damaged Meter Can Safety Inspection Panel Change DOH to UG j ' I
ther: ?e1bti:.1.I, R-15 2- svppo-c-ti-• P4i'N-SEA t\e 1•.t, (31,14 Gepd A1.
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. p
Owner Name: i2t)- Alky Phone Number: 90y "`ytofv'cj 144,
Electrical Company: COP-9..Q."-i- '1c2.0 et_kc4C C9A.A-2_ere.-A 30ffice Phone: 9O*- QR t- -705-0 Fax:
Co.Address: t 19 v1 3 OR. k V)O tz.At .. c,—•City: ,ylGi.•SPnville. State: FL Zip: 32-L Z 3
License Holder: MA 4.0- NI 42,0n044-4:44 State Certification/Registration tI: 6C la aoSZ,98
Notarized Signature of License Holder to..+.`-'\\.N4-e9.,•+
The foregoing instrument was acknowledged before methis l day o )e r 2f ( the State of Florida,County of
Signature of Notary Public
t p e'• TOP;I GiNDLE3PERGER
Personally Known OR[ ] Produced IdentificationMYCOMMISSION#GG 353178 cad` .• Type of Identification:
le. .,;o, EXPIRES:October 6,2023P0BondedThruNotaryPublicUnderwriters
OWNER:ADDRESS:CITY:STATE:ZIP:
SHOPPES OF A1A NORTH
LLC 4237 SALISBURY RD N STE 212 JACKSONVILLE FL 32216
COMPANY:ADDRESS:CITY:STATE:ZIP:
CURRENT ELECTRICAL
CONTRACTORS 11787 WORDSWORTH CT JACKSONVILLE FL 32223
TYPE OF
CONSTRUCTION:
REAL ESTATE
NUMBER:ZONING:BUILDING USE
GROUP:SUBDIVISION:
171090 0100 ROYAL PALMS UNIT 01
JOB ADDRESS:PERMIT TYPE:DESCRIPTION: VALUE OF WORK:
1221 MAYPORT RD
ELECTRICAL COMMERCIAL OR
MULTIFAMILY DETAILS PER BLDG
PLANS
REBUILD RISER - 7 SERVICES $1500.00
FEES
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
LIST OF CONDITIONS
Roll off container company must be on City approved list . Container cannot be placed on City right-of-way.
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.
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.
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.
1 of 2Issued Date: 9/1/2021
PERMIT NUMBER
ELPP21-0051
ISSUED: 9/1/2021
EXPIRES: 2/28/2022
ELECTRICAL COMMERCIAL OR
MULTIFAMILY DETAILS PER BLDG
PLANS PERMIT
CITY OF ATLANTIC BEACH
STATE DCA SURCHARGE 455-0000-208-0600 0 $2.00
TOTAL: $94.00
2 of 2Issued Date: 9/1/2021
PERMIT NUMBER
ELPP21-0051
ISSUED: 9/1/2021
EXPIRES: 2/28/2022
ELECTRICAL COMMERCIAL OR
MULTIFAMILY DETAILS PER BLDG
PLANS PERMIT
CITY OF ATLANTIC BEACH