Permit Addition 189 Magonolia 2012 . CITY OF ATLANTIC BEACH
i�1 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
,. INSPECTION PHONE LINE 247 -5814
.3i31
Application Number 11- 00002009 Date 4/28/11
Property Address 189 MAGNOLIA ST
Application type description ELECTRIC ONLY
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
kitchen
Owner Contractor
GUILMETTE BILL THOMPSON ELECTRIC CO, INC
49 WEST 7TH ST
ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233
(904) 249 -5601
Permit ELECTRICAL PERMIT
Additional desc .
Permit Fee . . . 58.60 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 10/25/11
Other Fees STATE ELEC DCA SURCHARGE 2.00
STATE ELEC DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 58.60 58.60 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 62.60 62.60 .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 (990 4) 247 -5845
JOB ADDRESS: /1. ne 40 /r 4'S PERMIT #
JEA INFORMATION REQUIRED ON ALL PERMITS /5 AMPS 2 1 VOLTS / PHASE
VALUE OF WORK $ FCot
NEW SERVICE ❑ Overhead ❑ Underground ❑l Underground up Pole
Residential (Main) Service
00 -100 amps ❑ 101- 150amps ❑ 151- 200amps ❑ amps # of Meters
❑ Commercial (Main) Service
❑ 0 -100 amps ❑ 101- 150amps ❑ 151- 200amps ❑ amps ❑CT 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 am.. :: : ; ps ❑ 200amps ii amps 0 C Service amps
ADDITIONS REMO I L PAIRS, BUILD -OUTS, ACCESSORY STRUCTURES, ETC.
Outlets/Switc es: 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 r
❑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 / � G1 6 Phone Number
Electrical Company ,& V/ 7a oil S a' -`mac_ 4 Office Phone 2 1 / f ` 9''iT6C/ Faxx c 7 z 7 �p
Co. Address: ! O , eC - 770/Sr City /4 ( sea ^ • Stat / Zip /
License Holder (Print): i / 4Olifi.(c9 PI S a j Certification /Registration # /Jo3Z/f '
/1 Notarized Signature of License Holder �� i
. worn and subscribed before • e this - ' day of 201/
1y r P DEBORAH a WHITE r
LT a MY COMMISSION # DD 634126
:1' _ ar ° EXPIRES: May 21, 2011 I ` . ignature of Notary Public r
/
" �, A Yaq`' Bonded Thru Notary °ublk Undetwrders J