Permit Security System 381 Seminole 2012 w J, ''
,ila
tli ' ; J u , 4 1 f CITY OF ATLANTIC BEACH
. 800 SEMINOLE ROAD
n ° = ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
Application Number 12- 00000321 Date 3/21/12
Property Address 381 SEMINOLE RD
Application type description ELECTRIC ONLY
Property Zoning TO BE UPDATED
Application valuation . . . 299
Application desc
INSTALL LOW VOLTAGE SECURITY SYSTEM
Owner Contractor
BURGOS, DANIEL R ADT SECURITY SERVICES INC
381 SEMINOLE ROAD 7818 PHILLIPS HWAY BLDG 1
ATLANTIC BEACH FL 322332536 JACKSONVILLE FL 32256
(904) 732 -7170
Permit ELECTRICAL PERMIT
Additional desc . SECURITY SYSTEM LOW VOLTAGE
Permit Fee . . . 90.00 Plan Check Fee . . .00
Issue Date . . . Valuation . . . . 0
Expiration Date . 9/17/12
Other Fees STATE ELEC DCA SURCHARGE 2.00
STATE ELEC DBPR SURCHARGE 2.00
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: 38 ( .S QIM 1 v 0 I e. 12 cJ/ 4 1 `ctirii c- tc`CL\ FL 3 223sPERMIT # /
JEA INFORMATION REQUIRED ON ALL PERMITS AMPS VOLTS PHASE
00
VALUE OF WORK$ 2 9 -
NEW SERVICE ❑ Overhead n Underground 1 J Underground up Pole
❑Residential (Main) Service
1 0 -100 amps ❑ 101- 150amps ❑ 151- 200amps il amps # of Meters
❑Commercial (Main) Service
_ 0 -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 iL] amps
SERVICE UPGRADE ❑ amps El CT Service amps
NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.)
❑ 100 amps D 150amps ❑200amps ❑ amps C - i CT Service amps
ADDITIONS, REMODELS, REPAIRS, BUILD -OUTS, ACCESSORY STRUCTURES, ETC.
Outlets /Switches: 0- 30atnps 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
1 Swimming Pool ❑ Sign ! i 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
[Ti Replace Burnt/Damaged Meter Can ❑ Safety Inspection L Panel Change ❑ OH to UG
X Other: Installing low voltage security system 12 volts 2 amps
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. (( pp
Property Owners Name _ ®Gt i Q 1 t7f 4 Phone Number 'b q - 2 3 7' 3
Electrical Company ADT Security Services Office Phone 904 - 732 -7100 Fax 904 - 732 -7760
Co. Address: 7818 Philips Hwy City Jacksonville State FL Zip 32256
License Holder (Print): _ o eP� . 7 j j am' State Certification/Registration # EF2000413
Notarized Signature of License Holder r/ , j e
..g N. Notary Public State of Florida Sworn and subscribed before me this e .0 da of MA 1 C. 20 12
Keith DePew d i EMy xpir Ces ommission 02/01!20E16 E 165279
f Signature of Notary Public 1 -