Permit Elec 1855 Beach Ave 2010 1 .4.4 "0
CITY OF ATLANTIC BEACH
1� 800 SEMINOLE ROAD
"41 ��� ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5826
°# Ji3i9i'
Application Number 10- 00001430
Property Address Date 12/02/10
BEACH
Application type description ELECTRIC ONLY
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
200 amp panel change
Owner Contractor
PANZER AMERICAN ELECTRICAL CONTRACTOR
1855 BEACH AVENUE 5065 ST. AUGUSTINE RD #13
ATLANTIC BEACH FL 32233 JACKSONVILLE
FL 32207
(904) 737 -7770
Permit ELECTRICAL PERMIT
Additional desc . PANEL CHANGE
Permit Fee . . . 90.00 Plan Check Fee
Issue Date .00
Valuation 0
Expiration Date . . 5/31/11
Other Fees STATE ELEC DCA SURCHARGE 2.00
STATE ELEC DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 90.00 90.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 94.00 94.00 .00 .00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
Ph (904) 247 -5826 F... (904) 247 -5845
IP
JOB ADDRESS:
,—.– 4 ,, , / Add PERMIT #
NEW SERVICE ( Overhead (l Underground ❑ Underground up Pole
❑Residential (Main) Service
❑ 0 -1 00 amps ❑ l 01- 150amps ❑ 151- 200amps ❑ amps # of Meters
❑ Commercial (Main) Service
❑ 0 -100 amps ❑ 101- 150amps 0 151- 200amps ❑ amps ❑ CT Service amps
Conductor Type Size
❑Multi- Family (Main) Service
❑ 0 -100 amps ❑ 101 - l 50amps ❑ 151- 200amps ❑ amps # of Unit Meters
❑ Temporary Pole ❑ amps
SERVICE UPGRADE 0 amps ❑ CT Service amps
NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.)
0 100 amps ❑ 150amps 0200amps 0 amps OCT Service amps
ADDITIONS, REMODELS, REPAIRS, BUILD -OUTS, ACCESSORY STRUCTURES, ETC.
Outlets /Switches: 0 -3 Damps 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
0 Swimming Pool 0 Sign 0 Smoke Detectors Qty 0 Transformers KVA ❑Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans & Fire Alarm Checklist)
Qty volts /amps VALUE OF WORK $
REPAIRS/MISCELLANEOUS
❑Replace Burnt/Damaged Meter Can 0 Safety Insp cti • ;
❑OH to UG
❑ Other:> C _ ;y I\,P \ - Va ( P, I
Permit 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
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 violat h: provisions of any other state or local law regulation construction or the performance of
construction. �j
Property Owners Name / y? / // � Phone Number
Electrical Compan '1/1 7/ &r--) / _ r/ / - 1 . / • ff ce Phone 7...'''.. # 7 Fax 73,'Z�O5
Co. Address: `/ 3 1 y (J - 5 J-in ' ' I s 1 Ci , •' - .1 1 'State a_ Zip _g • 0
License Holder (Print): 1 .4 atm �'. S : = C ification/Registration # P/) I s3 � �
Notarized Signature of L LicgneJJolder --'� —� I /
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...• DAY
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,,,,,, Comm# DD0854314 c Sworn and subscribed be ore mt this / day 6 f /: / e 20
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, 0 , 0 14, =. Exp ires 1/25/2013
� .h h Signature of Notary Pubh )1L -� )( i eir --„,.
%,,r; Florida Notary Assn., Inc
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