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1071 Atlantic Blvd - Electric Permit • �Lr Cash Register Receipt Receipt Number 't40 �~ City of Atlantic Beach R2434 DESCRIPTION ACCOUNT QTY PAID PermitTRAK $94.00 ELEC17-0008 Address: 1071 ATLANTIC BLVD APN: 177411 0040 $94.00 ELECTRICAL $90.00 ELECTRICAL BASE FEE 455-0000-322-1000 0 $55.00 ELEC REPAIRS AND MISC 455-0000-322-1000 0 $35.00 STATE SURCHARGES $4.00 STATE DBPR SURCHARGE 455-0000-208-0600 0 $2.00 STATE DCA SURCHARGE 45500002080700 0 $2.00 TOTAL FEES PAID BY RECEIPT: R2434 $94.00 CITY OF ATLANTIC BEACH 800 SEMINOLE RD ATLANTIC BEAC,FL 32233 08:31/2017 14:25:39 CREDIT CARD MC SALE Card F, X)IXXXXXXXXXX7687 SEQ#: 9 Batch#: 438 INVOICE 10 Approval Code: 112658 Entry Method: Marxial Mode: Online Card Code: M SALE AMOUNT 94,E CUSTOMER COPY Date Paid:Thursday, August 31, 2017 Paid By: AMERICAN ELECTRICAL SERVICES 0 Cashier: BA Pay Method: CREDIT CARD 10 Printed:Thursday,August 31,2017 2:26 PM 1 of 1 ,xwu,