Permit Elec for Lift Station 1969 Beach Ave 2011 a .;, CITY OF ATLANTIC BEACH
a .. �.r , r r y 800 SEMINOLE ROAD
J , x ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
4- 4.0111 r)'
Application Number 11- 00002180 Date 6/07/11
Property Address 1969 BEACH AVE
Application type description ELECTRIC ONLY
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
circuit for lift station
Owner Contractor
GREIDER, JACK FIRST CHOICE ELECTRIC
1969 BEACH AVENUE 716 VALLEY FORGE RD. N.
ATLANTIC BEACH FL 32233 NEPTUNE BEACH FL 32266
(904) 241 -1331
Permit ELECTRICAL PERMIT
Additional desc .
Permit Fee . . . 75.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 12/04/11
Other Fees STATE ELEC DCA SURCHARGE 2.00
STATE ELEC DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 75.00 75.00 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 79.00 79.00 .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
JOB ADDRESS: \ \ lcR c-- C..cs -c-� ■✓e..) PERMIT #
NEW SERVICE ❑ Overhead ❑ Underground ❑ Underground up Pole
❑Residential (Main) Service amps # of Meters
00 -100 amps ❑ 101- 150amps ❑ 151- 200amps ❑ amp
❑Commercial (Main) Service
00 -100 amps ❑ 101- 150amps ❑ 151- 200amps ❑ amps OCT Service amps
Conductor Type Size
❑Multi - Family (Main) Service
❑0 -100 amps ❑ 101- 150amps ❑ 151- 200amps ❑ amps # of Unit Meters
❑Temporary Pole ❑ amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.)
❑ 100 amps ❑ 150amps ❑ 200amps ❑ amps ❑ CT Service amps
ADDITIONS, REMODELS, 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:
OTHER ELECTRICAL PROJECTS
❑ Swimming Pool ❑ Sign ❑ Smoke Detectors Qty ❑ 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 ❑ Safety Inspection ❑Panel Change ❑ OH to UG
❑Other: C t_ft- -may 1 V\ c A, , r.,
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 performance of
construction.
Property Owners Name, - . e (.....✓ Phone Number 7.--q1- 1 3 31
Electrical Company o .�C" G-1- -41. t c=r E.->v 7 --,- C `/—` e-
Office Phone Fax
Co. Address: `7 1 c.s. \rcakk F ∎r<Ir R-A City ___ , - • ` 4 State —fi___ Zip _`Z? -
License Holder (Print): „ .... r--- State Certification/Registration #
Notarized Signature of Lice - - — _ - ty,
1 t
'��'� *' "- MY CDMMIS$IQN DD 95770 " of f 20 /1
-• . •, $WQMpa �,SeXibed , efore mei ,ei
-i t t Q^,P'' Bonded Thu Notary Public Underwriters 1 /
...7.1 • d 'Uel1C ' eL — ! t