Permit 67 Forrestal Cir 2011 elec upgrade CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
_77 ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5826
Application Number . . . . . 11-00001691 Date 2/17/11
Property Address . . . . . . 67 FORRESTAL CIR
Application type description ELECTRIC ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
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Application desc
service upgrade 150 amp 240 volt 1 phase
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Owner Contractor
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GRIFFIN, MAE RUTH SCHUMAN ELECTRIC INC.
67 FORRESTAL CIRCLE
ATLANTIC BEACH FL 32233 PO BOX 48171
JACKSONVILLE FL 32247
(904) 737-4040
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Permit . . . . . . ELECTRICAL PERMIT
Additional desc . . 150 AMP 240 VOLT PHASE 1
Permit Fee . . . . 115 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 8/16/11
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Other Fees . . . . . . . . . STATE ELEC DCA SURCHARGE 2 . 00
STATE ELEC DBPR SURCHARGE 2 . 00
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Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 115 . 00 115 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 119 . 00 119 . 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 Fax (904) 247-5845
-.s ADDRESS: I �-;rde- PERMIT#
NEW SERVICE 00verhead El Underground 0 Underground up Pole
Ei Residential (Main) Service
[10-100 amps 11101-1 50amps [1 151-200amps 1-]_amps of Meters
F1 Commercial (Main) Service
[-10-100 amps 0101-150amps 0 151-200amps []_amps EICT Service amps
Conductor Type Size
FiMulti-Family (Main) Service
110-100 amps 11101-1 50amps El 151-200amps 0-amps 4 of Unit Meters
[]Temporary Pole L1 amps
SERVICE UPGRADE ��g5o amps El CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
0100amps 11150amps 11200amps LJ_amps FICTService amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-3 Oamps _3 1-1 00amps -101-200amps
Appliances: 0-30amps _31-100amps -10 1-200amps
A/C Circuits: 0-60amps 61-1 00amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
DSwimmingPool 0Sign 0Smoke Detectors_Qty LITransformers KVA 0Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans &Fire Alarm Checklist)
Qty volts/amps VALUE OF WORK S
REPAIRS/MISCELLANEOUS
UReplace Burnt/Damaged Meter Can 0Safety Inspection El Panel Change 11OH to UG
Kther:- C C--e- 0 L
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 violate the provisions of any other state or local law regulation construction or the perfon-nance ol'
construction.
Property Owners Name V%47- Phone N umber A 6 7 A"Y
Electrical Company ;Xhwft0tr\ 1�vokrle- At- Office Phone AN-W-qdq6 Fax q 6q-34� -qLbL4
Co. Address: 3LO(P3 City -j-Q-&M6nu;k1e State FL- Zip
V- nse Bolder (Print): State Certification/Registration
A,,tarized Signature of License Hrolder
MICHELLE YOUNGSLOCWIvq�Zd"subscribed before me thisAjrj-+h,, day of In el -n--
NOTAFtY PUBLIC
STATE OF FLORIDA Signature of Notary Public
Cwn"EE0111692
Expirgs S/1 8/2014