1079 Atlantic Blvd # 9 2014 elec safety SSS CITY OF ATLANTIC BEACH
- - 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-ELEC-88
Job Type: ELECTRIC ONLY
Description: elec safety
Estimated Value:
Issue Date: 1/14/2015 1
Expiration Date: 7/13/2015 V"
PROPERTY ADDRESS:
Address: 1079 ATLANTIC BLVD
RE Number: 177416-0000
PROPERTY OWNER:
Name: HARBOUR PLACE PROFESSIONAL
Address: 13133 PROFESSIONAL DR STE 100 13133 PROFESSIONAL
DR STE 100
GENERAL CONTRACTOR INFORMATION:
Name: ALL SERVICE ELEC GROUP
Address: 1556 WHITLOCK AVE JOSEPH SULLIVAN/RICHARD
SPEAKE
Phone: - -
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Temporary Electrical Service $35.00
Trade Permit Base Fee $55.00
Total Payments: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERmiT APPLICATION /0I iw
CITY OF ATLANTIC BEACH (/0 LT
800 Seminole Rd, Atlantic Beach, FL 32233 7 Q Y
Ph(904)247-5826 Fax(904) 247-5845 h I�
JOB ADDRESS: /J 7 q L�r`� /Sfl Lk-Ni T -.79,52-7-3 PERMTT#
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NEW SERVICE ❑Overhead ❑ Underground ❑Underground up Pole
❑Residential(Main) Service
DO-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Meters
❑Commercial(Main) Service
00-100 amps 0101-150amps 0151-200amps ❑ amps OCT Service amps
Conductor Type Size
❑Multi-Family(Main) Service
❑0-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Unit Meters
❑Temporary Pole ❑ amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps ❑150amps ❑200amps ❑ amps ❑CT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-30amps 31-100amps 101-200amps
Appliances: 0-30amps 31-100amps 101-200amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
❑Swimming Pool ❑ Sign ❑Smoke Detectors Qty ❑Transformers KVA ❑Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans & Fire Alarm Checklist)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
❑Replace Burnt/Damaged Meter Can Safety Inspection ❑Panel Change 0 O to UG
❑Other: O c7VVIS411 U n
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 7W-J V 3. 6
Electrical Company&L �• '/l%��jC 61z'M4/(f a/LoA_o'1 �Office Phone�,� Fax 7W-4WO
Co.Address: /����� �t/�rT�OP�C /�� city .llE State /'Ll Zip.3/,;�-1/
License Holder(Print)• DSS' SGS l�'U State Certification/Registration A&Mgo �67&
Notari ed Si nature of License Holder
Sworn' subscribed before this �y day o 20/5—
MICHELE
M. SPEAKER
+ + = Notary Public-state o1 Florida,
My Comm.Expires Nov 8. 2016 Signa e of Notary Publi
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Commission#EE 843836