Permit Elec low voltage 1633 Beach 2012 �r�' J
..... {sue CITY OF ATLANTIC BEACH
CH
J 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
JJ f , INSPECTION PHONE LINE 247 -5814
Application Number 12- 00000408
Property Address 1633 BEACH AVE Date 4/10/12
Application type description ELECTRIC ONLY
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
LOW VOLTAGE
Owner Contractor
FARR JAY AND MARY SUPERIOR SIGHT & SOUND LLC
1633 BEACH AVE 7035 PHILLIPS HWY STE 9
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32216
Permit ELECTRICAL PERMIT
Additional desc .
Permit Fee . . . 90.00 Plan Check Fee .00
Issue Date Valuation 0
Expiration Date . . 10/07/12
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: /cep 33 ..,
v i • A 6pi cis_ PERMIT # /Z —O
JEA INFORMATION REQUIRED ON ALL PERMITS
--- - AMPS VOLTS PHASE
VALUE OF WORK $
NEW SERVICE Ell Overhead Ei
❑Residential (Main) Service Underground ❑T Underground up Pole
❑0 -100 amps ❑ 101- 150amps ❑ 1 51- 200amps ❑
❑ Commercial (Main) Service amps # of Meters
00 -100 amps ❑ 101- 150amps ❑ 151 -200am s
Conductor Type Size p ❑ amps ❑CT Service
❑Multi- Family (Main) Service amps
00 -100 amps ❑ 101 150amps ❑ 151- 200amps ❑
amps # of Unit Meters
❑ Temporary Pole ❑ amps
SERVICE UPGRADE ❑
amps Li CT Service amps
NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.)
❑ 100 amps ❑ 150amps 0200am s ❑
p amps El CT Service amps
ADDITIONS, REMODELS, REPAIRS, BUILD -OUTS, ACCESSORY STRUCTURES, ETC.
Outlets /Switches: 0 -30am s
Appliances: 0 -30am s 31- 100amps 101- 200amps
A/C Circuits: 0- 60amps 61- 100amps 101- 200amps
Heat Circuits: # p 61 100amps
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$
REPAmS/MISCELLANEOUS
❑Replace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change ❑OH to UG //
Other: i1 , Mt , - 9 � 23 . 2c
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 C. f
Phone Number 9 0g 2.2G i
Electrical Company „Etat • 1 ■ 2. IP C'
'r . . Office Phone Fax
Co. Address: I . . /Tp ] ) /,p S 1
{ ci ty 71
('f/ State `/ Zip c L- z,. ,,
License Holder (Print): ii3riGvv
State Certification/Registration #(.S (CO B 783
Notarized Signature of License Holder
(� Sworn and subscribed before •• - his / of A lf r-f 20/0
r J IZO Q0 7i3 Signature of Notary Public o n '
1/3///2.
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