1021 ATLANTIC BLVD UNIT 967 - ELECTRICAL r„ `r ✓c,,
;` . CITY OF ATLANTIC BEACH
�9
jl 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: 16-ELEC-621
Job Type: ELECTRIC ONLY
Description: UNIT 967 5 FIXTURES
Estimated Value:
Issue Date: 3/15/2016
Expiration Date: 9/11/2016
PROPERTY ADDRESS:
Address: 1021 ATLANTIC BLVD
RE Number: 177602-0040
PROPERTY OWNER:
Name: EQUITY ONE ATLANTIC VILLAGE,
Address: 16 NE MIAMI GARDENS DR ATTN: TREASURY DEPT
GENERAL CONTRACTOR INFORMATION:
Name: KNIGHT ELECTRIC LLC
Address: 908 S 11TH AVE QA MARK STEVEN KNIGHT
Phone: - -
FEES:
Trade Permit Base Fee $55.00
State Elec DCA Surcharge $2.00
State Elec DBPR Surcharge $2.00
Lighting Outlets, Including Fixtures $3.00
Total Payments: $62.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
el^ CITY OF ATLANTIC BEACH
I�1i` Seminole Rd, Atlantic Beach, FL 32233
W 800 Ph(904)247-5826 Fax (904) 247-5845
JOB ADDRESS: 9v 7 /97L /ii- EiicZ PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS AMPS 2)10 VOLTS / PHASE
VALUE OF WORK$
NEW SERVICE ❑ Overhead n Underground I IJ Underground up Pole
❑Residential(Main) Service
00-100 amps U 101-150amps U 151-200amps 0 amps #of Meters
❑Commercial(Main)Service
1 00-100 amps 1101-150amps U 151-200amps f_i amps OCT Service amps
Conductor Type Size
ii]Multi-Family(Main)Service
110-100 amps U 101-150amps 0151-200amps Li amps #of Unit Meters
Li Temporary Pole U amps
SERVICE UPGRADE 0 amps U CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
[1100 amps U 150amps 0200amps 0 amps 0 C Service amps
tDDITIONS,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: $
)THER ELECTRICAL PROJECTS
°Swimming Pool U Sign °Smoke Detectors Qty °Transformers KVA ❑Motors hp
IRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps • VALUE OF WORK$
EPAIRS/MISCELLANEOUS
°Replace Burnt/Damaged Meter Can 11 Safety Inspection ❑Panel Change UGH to UG
U Other:
unit 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
.d 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
:cified 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
istruction. [ .}
Dperty Owners Name Cv1ll IS .1.r i4. Pao Phone Number
.ctrical Company vt 1r Lt C (C- LLC-
Office Phone Fax
. Address: 7"t ' e- ccefrk City T9-4 l' 4 State fi Zip 322c6
ense Holder •e t : m 4 r State Certification/Registration# E12/36(ZS 29
!_
tarized Sig ii la f �i�j�k florida -� M&; t;y Commission t � me ' is /_. ,ay /, A �./ '0 �I
of ci c.tp1-res 02/14/2 `L
Signature of Notary P ���_ •�Nor