Permit Elec surge suppressors 850 Seminole 2010 S f
; � t ' CITY OF ATLANTIC BEACH
U � n�� .��a�. .:"..r: 800 SEMINOLE ROAD
` ATLANTIC BEACH, FL 32233
" } INSPECTION PHONE LINE 247-5826
Application Number
Property Address . . . • • 10- 00 001308
Application type description 850 SEMINOLE RD Date 10/27/10
Property Zoning ELECTRIC ONLY
- - - -- Application valuation RES SF DISTRICT
Application desc
0
______
SURGE _PROTECTORS
------ - - - - -- - _____________________________
Owner ---------------------------------------
Contractor
EXUM COMM & ELECTRIC
3413 -1 SOUTHSIDE BLS INC
J ACKSONVILLE
-- ---- --- - - - - -- (904) 646 -9917 FL 32216
Permit --------- - - - - -- __________
Additional desc ELECTRICAL PERMIT ---- - - - - -- _
Permit Fee •
Issue Date • . 90.00 Plan Check Fee
Expiration Date . Valuation
.00
---- - - - - -- ------ - - - - -- 4 /25/11 0
Other Fees -------- ------ __
• • . STATE ELEC DCA SURCHARGE
-- ------ ------ STATE ELEC DBPR SURCHARGE 2.00
- --- - - - - -- ___ ____
ed Paid Credited
g - -- - _--_ - _ - ---------
Fee summary Charged
Permit Fee Total 90.00
Plan Check Total 90.00 .00 00
.00 00 . .
00 00
Other Fee Total 4.00 4.00 .00
Grand Total 94.00 94.00 .00 •00
.00
w , C` l, a CITY OF A TL PM
MACK ORDIN LI�CES AND THE FLORIDA
Ca
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
Ph (904) 247 -5826 Fax (904) 247 -5845
JOB ADDRESS: v Seek ti L - -
d
PER1vIIT #
NEW SERVICE D
Overhead
❑Residenfiai ❑Underground C] Underground up Pole
(Main) Service
00 - 100 amps ❑ 101- 150aulps ❑ 15 1- 200amps ❑
G P s # of M eters
(Main) Service
❑ Commercial
❑0-100 amps 0101 -150am s
P ❑ 15 1- 200amps ❑
Conductor Type -- -__cps OCT Service amps
Size
❑Multi Family (Main) Service
00 -140 amps ❑ 101 -150am s
P ❑ 15 1- 200amps ❑
❑Ten ora - ---- -cps # of Unit Meters _
SERVICE UPGRADE ❑ cps
❑ - -GPs ❑ CT Service cps
NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.
❑ 100 amps ❑ 150amps 0200amps ❑ )
- - -GPs ❑ CT Service cps
ADDITIONS, REEMODELS, REPAIRS BUILD
UILD-OUTS, ACCESSORY STRUC
_ _0- 30amps ----_ — _ 31- 100amps I-200a ps
Appliances: 0 -3Oam s ___ ____10- 200am
A/C Circuits: 0- 6 p 61- 100amps 10I- 200amps
Heat Circuits: 0amps 61- IOOamps
g II circuits @ kw
Number of Lighting Outlets, Including Fires:
DTHER ELECTRICAL PROJECTS
❑Sg Pool ❑Sign ❑Smoke Detectors
Qty ❑Transformers KVA ❑Motors h
'IRE ALARM SYSTEM (Requires 3 sets of plans & Fire Alarm Checklist) p
Qty volts /amps VALUE OF WORK $
EPAIRS/MJS CELLANE O US
OReplace Burnt/Damaged Meter Can ❑Safety Inspection OPanel Change 00H to UG
pother: -.ZNS 7 ( SU 2C)-
pct -a-c--7 , o/t) (-c� o � L-E- /41 /1-4.0. /s
-rmit 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
id 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
.tcified 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
nstruction.
•operty Owners Dame C Og kite i i4 G 'I4
Phone Number
ectrical Company EXUnil EC��e 1 C A) CD
Office
j� / Phone 6} �r 9q ►) Fax (p t.i Z 7( Z
1. Address: ? 7 13 --� / . CO Lit 1 . E[. vd City -f 46. 1 ov�c ��
d State Cl Zip 3
sense Holder (Print): 4 - I_ % b Look ti State Certification/Registration # E -Ooco B99
►tasr. Signature of License Holden Altar ...1 .11
MY COMMISSION # 7 6 DD 950 I
20 A
Sworn' and subsc before i4 (Ilart f txPIR :- .,
Signature of Notary Public T %7P &LJ. ,
L5 5/G L/ 20! _6