Permit Elec 381 5th St 2011 A i" ✓rl
'- °} CITY OF ATLANTIC BEACH
�. ' ;, s� 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
r 0 .21
Application Number 11- 00002386 Date 7/25/11
Property Address 381 5TH ST
Application type description ELECTRIC ONLY
Property Zoning TO BE UPDATED
Application valuation . . . 1000
Application desc
CHANGE OUT PANEL
Owner Contractor
MORRISSEY MELISSA ENTERPRISE ELECTRICAL CONT OF
381 5TH ST NORTH FLORIDA, INC
JACKSONVILLE FL 32202 14286 -19 BEACH BLVD #176
JAX BEACH FL 32250
(904) 312 -3495
Permit ELECTRICAL PERMIT
Additional desc . CHANGE OUT PANEL
Permit Fee . . . 90.00 Plan Check Fee .00
Issue Date Valuation . 0
Expiration Date . . 1/21/12
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 Fax (904) 247 -5845
JOB ADDRESS: 35/ .j Sr PERMIT #
JEA INFORMATION REQUIRED ON ALL PERMITS __AMPS 04%/0 VOLTS / PHASE
VALUE OF WORK $
NEW SERVICE ❑ Overhead ❑ Underground ❑J Underground up Pole
❑Residential (Main) Service
❑0 - 100 amps ❑ 101- 150amps ❑ 151- 200amps ❑ amps # of Meters
❑Commercial (Main) Service
❑ 0 -100 amps ❑ 101- 150amps ❑ 151- 200amps ❑ amps 0 C 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 anel Change ❑ OH to UG
❑ Other:
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 t 57 A rt /5Sey Phone Number qc /— ` S cr9_ ,30,E
Electrical Company / 2�p S G 5pp� �',i,il ( , Office Phone @-/- 33if-Sk Fax yw 74/
of= w F'a,' is L
Co. Address: 151 - fij 6 ,2, , 5) he , 0 City .3'cc - k5alu zt a State ! Zip , 3A4.; )
License Holder (Print): 11 , „ ' 1 S , ,r i Stat- Certification/Registration # e /3U/,�,.5g6
Notarized Signature of License Holder 1/ /ir� ;
"" DEBORAHAMANDA orn and subscribed before t is 2S d of � ' � 20//
fe 11, mid MY COMMISSION # EE 05734
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Bonded ThN Notary Pu EXPIRES: Ma bl 21 k '924°4 15 l e 5 hers gnature of Notary Public
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