Permit Elec 2109 Fleet Landing 2012 r. � - CITY OF ATLANTIC BEACH
4"4 . s 800 SEMINOLE ROAD
, ' ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
J1 W
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Application Number 12- 00000130 Date 1/31/12
Property Address 2109 FLEET LANDING BLVD
Application type description ELECTRIC ONLY
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
1 OUTLET
Owner Contractor
NAVAL CONTINUING CARE CURTIS DUVALL ELECTRIC
FLEET LANDING 281 HORSETAIL AVE
1 FLEET LANDING BOULEVARD MIDDLEBURG FL 32068
ATLANTIC BEACH FL 32233 (904) 654 -5269
Permit ELECTRICAL PERMIT
Additional desc .
Permit Fee . . . 55.60 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 7/29/12
Other Fees STATE ELEC DCA SURCHARGE 2.00
STATE ELEC DBPR SURCHARGE 2.00
Fee summary Charged Paid Credited Due
Permit Fee Total 55.60 55.60 .00 .00
Plan Check Total .00 .00 .00 .00
Other Fee Total 4.00 4.00 .00 .00
Grand Total 59.60 59.60 .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 (904) 247 -5845
JOB ADDRESS: 2 t v c ( F I -L (..0 j In gVLb PERMIT # / Z " /cZ
NEW SERVICE ❑Overhead ❑ Underground ❑ Underground up Pole
❑Residential (Main) Service
00 -100 amps ❑ 101- 150amps ❑ 151- 200amps ❑ amps # of Meters
❑ Commercial (Main) Service
00 -100 amps ❑ 101- 150amps ❑ 151- 200amps ❑ amps OCT 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 OCT Service amps
ADDITIONS, REMODELS, REPAIRS, BUILD -OUTS, ACCESSORY STRUCTURES, ETC.
Outlets /Switches: i 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
❑ 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 at r•4o r✓ Cc - Pe Phone Number 5 92- 6'6 7/
Electrical Company aid. b &/ 7-;,..e Office Phone €, S`r s2 (9 Fax
Co. Address: 2. 8/ a; [ i4 ;rtd City r1.1 CO(Lh,,cc State L. Zip 32068
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License Holder (Print): C.,vcirr S bin! l State Certification/Registration # - 2/30 u s-6-9,
Notarized Signature of License Holder _ 1
+4' ' " = TIFFANY SAUNDERS orn and subscribed befor me th O` day 20
; ;,,_. MY COMMISSION # OD 828498 gn ature of Notary Public 4--Ralk-A0— 2S 4 "
y.°,;,;; EXPIRES: September 28, 2012