1013 ATLANTIC BLVD SAFETY INSPECTION 2014 � .' S CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
ELECTRICAL PERMIT INSPECTION PHONE LINE 247-5814
0 ALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
]OB INFORMA
Job - -
Job Type: ELECTRIC ONLY
Description: SAFETY INSPECTION
Estimated Value:
Issue Date: 10/13/2014
Expiration Date: 4/11/2015
PROPERTY ADDRESS:
Address: 1013 ATLANTIC BLVD
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: EAGLE ELECTRIC INC.
Address:
Phone: - -
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Electrical Repairs $35.00
Trade Permit Base Fee $55.00
Total Payments: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
Ph(904) 247-5826 Fax(904) 247-5845
JOB ADDRESS: �L kLan i c'_ F) � 11 � fl
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I � lV� � AT'QV1�' C•EA, FL, PERMIT
JEA INFORMATION REQUIRED ON ALL PERMITS anC)_AMPS �O 3 VOLTS _3 PHASE
VALUE OF WORK$ JCC ,no
NEW SERVICE ❑ Overhead ❑ Underground ❑1 Underground up Pole
❑Residential(Main) Service
❑0-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Meters
❑Commercial(Main) Service
❑0-100 amps ❑101-150amps ❑151-200amps F1------amps ❑CT Service amps
Conductor Type Size
❑Multi-Family(Main) Service
00-100 amps ❑101-150amps ❑151-200amps ❑ amps # of Unit Meters
[]Temporary Pole ❑ amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps ❑150amps ❑200amps ❑ amps [I CT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-30amps 31-l 00amps 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:
OTHER ELECTRICAL PROJECTS
❑Swimming Pool ❑ Sign ❑Smoke Detectors_Qty ❑Transformers KV A ❑Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
❑Replace Burnt/Damaged Meter Can Xsafety Inspection ❑Panel Change ❑OH to UG
❑Other:
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.
Property Owners Name Phone Number
Electrical Company Office Phone 796-0797 Fax 7Ry L//
- E7
Co. Address: f�Q Sf, n�rc�c1�S City a cxSo n v j I e State-(-�L Zip, q
License Holder(Print): 1 State Certification/Registration# L0. mon 6 7Y
Notarized Signature of License Holder
o��PY pv Sworn and subscribed before me this_3 day of O c•-fin to e r 2011/
a ;•••.°�� DARLEENM.HERBMWN g Notary
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* * MY COMMISSION►EE 110829 Signature of Nota Public 4
EXPIRES:August 1,2015
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