Permit 269 Sailfish Dr elec safety CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 11-00002498 Date 8/16/11
Property Address . . . . . . 269 SAILFISH DR
Application type description ELECTRIC ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
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Application desc
safety inspection
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Owner Contractor
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CRAWFORD ELECTRIC
P.O. BOX 51045
JAX BEACH FL 32240
(904) 241-5591
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Permit . . . . . . ELECTRICAL PERMIT
Additional desc . .
Permit Fee . . . . 90 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 2/12/12
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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 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: PERMIT#_11_C)y99
JEA INFORMATION REQUIRED ON ALL PERMITS AMPS/2444)OVOLTS PHASE
VALUE OF WORK$
NEW SERVICE 0 Overhead Underground Underground up Pole
OResidential(Main) Service
E10-100 amps [I 101-150amps 11 151-200amps amps #of Meters
El Commercial(Main) Service
EO-100 amps El 101-1 50amps El 151-200amps O—amps OCT Service amps
Conductor Type Size
LIMulti-Family(Main) Service
LIO-100 amps El 101-150amps 11 151-200amps 11 amps #of Unit Meters
[I Temporary Pole El amps
SERVICE UPGRADE El__________,amps 11 CT Service_amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
11100amps 11150amps 11200amps 0 amps OCT 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
El Swimming Pool El Sign []Smoke Detectors_Qty El Transformers KVA Ll Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans& Fire Alarm Checklist)
Qty volts/amps VAL UE OF WORK$
REPAIRS/MISCELLANEOUS
EReplace Burnt/Damaged Meter Can VSafety Inspection OPanel Change E�OH to UG
F1 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 al', 4�_r 5 C' Phone Number
Electrical Company DLO Q�-A e-I-e-G If, L Office Phone Fax 2,4003)
Co.Address: City State_Zip
License Holder (Print): State Certification/Registration#
Notarized Signature of License Holder
Sworn and subscribed before me this day of 20
Signature of Notary Public