Permit Elec 91B Dudley 2010 t ' _ .. CITY OF ATLANTIC BEACH
s j 800 SEMINOLE ROAD
'- ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5826
Application Number 10- 00001352 Date 11/08/10
Property Address 91 DUDLEY ST B
Application type description ELECTRIC ONLY
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
water heater
Owner Contractor
JACKSONVILLE HOUSING AUTHORITY VANGUARD ELEC CONTRACTORS
2375 ST JOHNS BLUFF RD S
ATLANTIC BEACH FL 32233 STE 310
JACKSONVILLE FL 32246
Permit ELECTRICAL PERMIT
Additional desc .
Permit Fee . . . 57.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 5/07/11
Other Fees STATE ELEC DCA SURCHARGE 2.00
STATE ELEC DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 57.00 57.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 61.00 61.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMff APPLICATION .
• CITY OF ATLANTIC BEACH
-( 800 Seminole Rd, Atlantic Beach, FL 32233
Ph (904) 247 -5826 Fax (904) 247 -5845
OB ADDRESS: 4 O, d ley _S-1-, & PERM rr #
fEW SERVICE DOverhead 0 Underground 0 Underground up Pole
DResidential (Main) Service amps # of Meters
00 -100 amps ❑ 101- 150amps ❑ 151- 200amps ❑ amp
❑Commercial (Main) Service
00 -100 amps 0101- 150amps 0151- 200amps ❑ amps OCT Service amps
Conductor Type Size
❑Multi-Family (Main) Service # of Unit Meters
00 -100 amps ❑ 101- 150amps ❑ 151- 200amps ❑ amps
❑Temporary Pole ❑ amps
ERVICE UPGRADE ❑ amps ❑ CT Service amps
fEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.)
❑ 100 amps ❑ 150amps 0200amps ❑ amps OCT Service amps
.DDITIONS, REMODET S, 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:
ITHER ELECTRICAL PROJECTS
0 Swimming Pool ❑ Sign 0 Smoke Detectors Qty ❑Transformers KVA ❑Motors hp
IRE ALARM SYSTEM (Requires 3 sets of plans & Fire Alarm Checklist)
Qty volts/amps VALUE OF WORK $
tEPAIRS/MISCELLANEOUS
❑Replace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change ❑OH to UG
Other: 1i nne C In c K / b s c_ofF1 . c_.1
ermit becomes void if work does not continence within a six month period or work is suspended or abandoned for six moths. I hesebly certify that I have
ad this application and know the same to be true aid correct All provisions ()flaws and adaaaoocs governing this work wM be complied with whether
ncifted or not The pamit does not give authority to violate the provisions of any other state or local kw regulation construction or the performance of
aostruction.
,ropes, Owners Name Phone Number
:ledrical Compan J t A ' C LA // �� C.tAAr ' .c� 1Yi /�'Z � Office Phone d3 a -' 0 d $ Fax c93.2 —(
;o. Address: 3 5 3 ' nir' FJ ev- 1 ).-+- - h D 7 Cit State - -e . Zip 3 a 2 a L.
Cn (1 rr t- ( t Lt-)C 4P [ State ' cation/Registration # E C 1 30')3 - 7 1
,iceerise Holder (Print): l� . +�-� �
atarized Signature al Lierrse ffclder s Ll °P1 _
, • • and subscribed before me this 5) day of 20 1
�►gY ^ Nota Publi State of Florid ' '
l l\ Gini B iz a i _ 'r >, of Notary Public .
a M Commission 00969544
• 0 , TT ° ° ° Expires 03 /30/2014