150 12th Street 2012 UG elec service CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-00000022 Date 1/06/12
Property Address . . . . . . 150 12TH ST
Application type description ELECTRIC ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
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Application desc
INSTALL 311 UG SERVICE CONDUIT TO EXISTING METERCAN
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Owner Contractor
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ADKISSON KENDALL SCHUMAN ELECTRIC INC.
150 12TH STREET
ATLANTIC BEACH FL 32233 PO BOX 48171
JACKSONVILLE FL 32247
(904) 737-4040
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Permit . . . . . . ELECTRICAL PERMIT
Additional desc . . UG SERVICE CONDUIT TO METERCAN
Permit Fee . . . . 90 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 7/04/12
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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 [leach, i'l, 32233 <71
Ph (904) 247-5926 Vax (904) 247-5845
4 ADDRESS: ) ,S--o I a-114 . S—) - PERMIT
JEA INFORMATION REQUIRED ON ALL PERMITS AMPS ? -10 VOLTS PHASE
VALUE OF WORK$ 15VO, 0-0
NEW SERVICE 0 Overhead F-1 Underground XUnderground up Pole
,-iResidential(Main) Service
D 0-100 amps �<l 0 1-I 50arlips 151-200arrips —arnps 9 of Meters
Commercial(Main) Service
Fj 0-100 amps 1101-150amps 151-200amps
amps CT Service arrips
Conductor Type Size
F-�Multi-Family(Main)Service
0 0-100 amps 10 1-1 50amps I 51-200amps
.—amps 9 of Unit Meters
I Temporary Pole P_amps
SERVICE UPGRADE L-J—amps L-i CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
D 100 amps L,150arnps J200amps � ]_amps CT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-30amps 3 1-1 00amps 101-200amps
Appliances: 0-30arnps 3 1-1 00amps 101-200amps
A/C Circuits: 0-60amps 6 1-1 00amps
Heat Circuits: 4 circuits @ kw
Number of Lighting Outlets, Including iFix—tures:
OTHER ELECTRICAL PROJECTS
DSwimming Pool D Sign DISmoke Detectors—Qty �'Transformers KVA Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans & Fire Alarm Checklist)
Qty_volts/amps VAL UE OF WORK S
REPAIRS/MISCELLANEOUS
UReplace Burnt/Damaged Meter Can I Safety Inspection Panel Change 'I OH to UG
*ther: ce- Co)�30,uT 'T-D F-� �ynvJCA qmcl�- C Pw,)
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 h
read this application and know the same lobe 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 h6t?eLy 55 d'(7 Phone Number
Electrical Company 7fs C4�-�—VXI� C. -T--3c - -Office Phone 73 7-�-(OLI 0 Fax -3 -C(l D If
Co. Address: �o Q S-( - NA-k::)Ng. City
. ccio I _ K-56�c iLState Zip 3 Z?- 1 7
1 � -nse Holder(Prin*--ro 111� "�V-""\0yy'j' ci� State Certification/Registration E&130 Gl-li L4
Autarized Signature of License Holder
MICHELLE YOUNGBLOOD
NOTARY PUBLIC Sworn and subscrihed befor th* day of D,017W24-il 2012
STATE OF FLORIDA
Comm#EE01802 Signature of Notary Publ ic
Expires 8/16=14