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ATLA UILDING,DEPARTMENT
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43
CITY OF ATLANTIC BEACH, FLORIDA
Approved by APPLICATION FOR ELECTRICAL PERMIT
TO THE CHIEF ELECTRICAL INSPECTOR; DATE:—/?
IMPORTANT NOTICE:
IN CONSIDERATION OF PERMIT GIVEN FOR DOING THE WORK AS DESCRIBED IN THE FOLLOWING, WE
HEREBY AGREE TO PERFORM SAID WORK IN ACCORDANCE WITH THE ATTACHED PLANS AND SPECIFICATIONS,
WHICH ARE A PART HEREOF, AND IN ACCORDANCE WITH THE ELECTRICAL REGULATIONS, CODES AND CITY OF
ATLANTIC BEACH ORDINANCES.
/4-L _561411,-s,
'fGNAfURE
ELECTRICAL FIRM: MA ELECTRICIAN S JOURNEYMAtj
-7
NAME A&DRESS: RFD—BOX
BLDG.SIZE BETWEEN:
RES.( ) APT.( I comm.04 PUBLIC INDUS. NEW( OLDI REW. I
ADDITION ) TRAILER ( I TEMP.( ) SIGNS ( ) SO. FT.
SERVICE: NEW( INCREASE( ) REPAIR FEE
CONDUCTOR SIZE AMPS COPPER ALUM.f
SWITCH OR BREAKER AMPS PH W VOLT -RACEWAY
EXIST.SERV.SIZE AMPS PH W VOLT RACEWAY
FEEDERS NO-. SIZE INO. SIZE -NO. SIZ
LIGHTING OUTLETS CONCEALEDI OPEN I TOTAL
RECEPTACLES CONCEALED � OPEN I TOTAL
1 0.30 AMPS. 31-100 AMtSd
SWITCHES
INCANDESCENT
FLUORESCENT&M.V.
FIXED 0.100 AMPS. OVER
APPLIANCES I YSF.
AIR H.P.RATING H.P. RATING
CONDITIONING COMP.MOTOR OTHER MOTORS AMPS CEIL HEAT: KW-HEAT
137 fC,,V
0-1 OVER
MOTORS H.P. VOLTAGE PHS NO. I H.P. VOLTAGE PHS1
_70
MISCELLANEOUS
TRANSFORMERS: UNDER 600 V. OVER 600 V.
NO. KVA 1_1 lKVA
NO.NEON TRANSF.' [NO. VA. MA. MOTOR SIZE SWITCHI FLASHER
EACH SIGN
FORWARDED
TOTAL FEES 17, 5-03
p
F BUILAINd
DIEPARTMEXT 01
C BEACk
CITY OF ATLANTI
LOCATION INFOR
NATION ---------
kR111TANFORNATION
'1452:1
%AYPORT ROAD
Addro"-"
"Of"t Humbert
LANTIC BEACH, FLORIDA 32233
T,,
i,77
t ESCRIPTION ----------
LEGAL D
f ADDITION
CONCRETE Lot% Blocki Section:
an r
0
d OFFICE BUILDING
oposo *e
Subdiyipi,013 2 ,
Ain 0
Code:
$0.00
00100
Total -Feem
7/,92, ,
-`Ww, TRAL 'A�R CONDIT
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APPLICATION FEES
7
tkw,?� "PER11 I
T
MATION $45. 00
'T FEE
WATER IMPAC
ROAD,
'92 3
CH, ' FLORID 0 k FEE
04-1
A
-H,, R.S. 0-0,
RADON GAS 5%
mai C, ABING WATER TAP $0.00
wam-M.-k- SEWER -TA $0.00'
SHARE $0. 00
RAUL C
JAC TLLEV Pl..'. 32204
0 Typo: 1 00
111PACT FEE �6.,*Qo
sc
g
4401,0�
NQT-j4p9-'-ALL CONCAIETE,FdRlhill AND FOOTINes MqsT j3S,jNsf%CTp-0 13EFORE PdURING
PERMIT VOID SIX MONTHS AFTER DATE OF I$SUE,
MATERIAL,RUBBISH ANODEBRIS FAOM,THIS WORK MUSTTINOT BE PLACED IN PUBLIC SPACE,'AND MUST BE
BQJLDING
q�ARED UPAND HAULED AWAY BY EITHER CONTRACTOR OR OWNER.
NARSULT IN
C MECHAt $1, LWN lAW CA
AILU. E TO, TWIC ,
OM
TS,
0 LDI
Aymo E FOR U
P I NO IMPROVE
ALM1104-A4*1 wunge
AND SU Z
kUED ACCORD ARE PART OF THIS PERMIT AND SU
LAN$,WHICH 0 SU
0 SU A
ING TO APPROVED,P
LA' I N F,
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OVI IONIS OFLA
19.0mgm;No"m
AS
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'NT110 SEA
CH�BUILDINGD,15 -AATMENT
BUILDING AND ZONING INSPECTION DIVISION
CITY OF ATLANTIC BEACH
ATLANTIC 69AC". FLORIDA 331233
APPLICATION FOR MECHANICAL- PERMIT CALL-IN NUMBER
IMPORTANT — Applicant to complete all items in sections 1. 11, 111, and IV,
Street Address:
LOCATION
OF - Intersecting Streets: 101witess at And
WILDING
11. IDENTIFICATION To be completed by all applicants
In cons;deraf;on of pistrn;# given for doing the worit as described in this abeve statement we hereby agree to re-le— sa;d -o-a
W'th the stfachjId plaits and specifications which are a part hereof and in accordance with the C.*fy of Jiteksoriv.1'st ord�#%*"csts a-4 est---s-z'
of good practice listed #her@;".
Name *I Mechanical contractors
ceatracter (Frio#) ry ts 0 rk—1 J
Nismar of
Prispeol Owner z— e7k�/
�oature 04 Owner Signature of
Awtker;z#d Agent Architect or_Engineer
III. G-MULAL INFO��
A, Towof h"fing fool: Is OTHER CONSTRUCTION 49INQ 0
(3 Eistotic THIS *UILOING an SITE 7
(3 Sea—E) V E3 Natural E3 C60#01011 UORY IF YES, Give NUMBER Or CONSTRUCTION
C) 04 PERMIT
00W — speciiff
IV. M@CK4M" 6QUIPUba TO 81 INSTALUD NATURE OF WORK
(p @As cenpIatiss IM of cowoossents cia bect of this 116#101 Residential Or A Commercial
C3 "*&1 13 Spec* E] Itsicanatil 13 Now Building
J?L AkC-04W*Niftql: 13 It"a br-000001 EXIStIng BUIlding
13 " Systems- M&0066L�-- Replacement of existing system
C3 New installation(No systern prevIoUsly 111816110d)
0 Extension at add-on to existing systern
0 lt*4i"mti" 0 Other —ep"Ify
13 coon" seww: cepecily I-P^
Ej rin, Wr;ftjIM.
"Vfflbet of L—A.
T
C) fle"W C) mesdift C3 Iscatissfe- THIS 2PACII FOR CMICI US4 ONLY
0 Cpascilisse PUMPL. -Issombeir) (R"oivodl
0 -A. -- ASMAI
D ca"ft.
0
Pe"PA Appovemif L-
C) 00W
LIST ALL XQUIPMENT
AM COND1710MNG A140 REFRIGERATION EQUIPMENT C* AppsevrUg
jpadty
NVA,b"VISNA Dft9!!!n Model Number Koweettuer (701111) ASIOCy
jwATnNG I FMACES, BOILERS, FIREPLACES
C ty Appnistift 01
Rmber Usdts DesertPues Me"NUmber X11.021"tWIVI! (RM)
7)w— A
TANKS
www Many Nowba Capatelty Type U4Wd Name ad saw 4pZving
and DkI111411111ims Oontained xamdmtww No. nc