1089 Atlantic Blvd. #2 - Elec Safety Inspection �J s\ CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
'.)1101 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: 16- ELEC -66
Job Type: ELECTRIC ONLY
Description: Safety Inspection
Estimated Value: $250.00
Issue Date: 1/11/2016
Expiration Date: 7/9/2016
PROPERTY ADDRESS:
Address: 1089 ATLANTIC BLVD UNIT 02
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: ARC FLASH ELECTRIC, CORP
Address: 406 Madison AVE Suite 7 QA ALLEN JAMES EIMERS
Phone: 904 - 579 -4629
FEES:
Electrical Repairs $35.00
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
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 I — U,-- _,C.. rL
CITY OF ATLANTIC BEACH 41 . / / �1
800 Seminole Rd, Atlantic Beach, FL 32233 �
Ph (904) 247 -5826 Fax (904) 247 -5845 .-�.= t �"`rO�� ,..
JOB ADDRESS: ASH PROP)ERITES 1089 ATLANTIC BLVD. SUITE #2, ATLANTIC BEACH, FL 32233_PERMIT #
JEA INFORMATION REQUIRED ON ALL PERMITS 100 AMPS _120/208_ VOLTS Single_ PHASE
VALUE OF WORK $440.,..5"0, c.°
NEW SERVICE ❑ Overhead 1 Underground ❑J Underground up Pole
^Residential (Main) Service
C0 -100 amps L 101- 150amps - 151- 200amps iT amps #t' of Meters
xCommercial (Main) Service
x0 -100 amps C 101- 150amps ::151- 200amps f _ amps J CT Service amps
Conductor Type Size
i Multi- Family (Main) Service
0 -100 amps :101 150amps J151-200amps = amps # of Unit Meters
Temporary Pole : amps
SERVICE UPGRADE E.1 amps L CT Service amps
NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.)
:100 amps L,J 150amps C200amps E 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 C Sign Smoke Detectors _ Qty - Transformers KVA 7IMotors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK $
REPAIRS/MISCELLANEOUS
-._ Replace Burnt/Damaged Meter Can xSafe Ins pect; 0 Panel Change 00H 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. 1 hereby certify that 1 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 Owner: Asigroperties Phone Number
Electrical Company Arc Flash Electric Corp. Office Phone (904) 704 -3420 Fax
Co. Address: 406 Madison ,Ave. #7. City Orange Park State FL Zip , 32065
License Holder (Print): A- ! /e viT / , (r) .1?teS - State Certification/Registration # EC- 13003871
Notarized Signature of License Holder , , A • • / - - _ it r r )t- ,tni • atb- 11-36L -t
SgNYA N. J Sworn and subscribed before me this (.0 day of _lama 20 S (p
.., : C # FF 910126
.- ,. E x�i ce� a� �t lt . _ Si atureofNotar Public Cie �--
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