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61 Beach Cottage Ln elec safety 2012 IN` 1 CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD J ATLANTIC BEACH, FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 12-00000698 Date 6/05/12 Property Address . . . . . . 61 BEACH COTTAGE LN Application type description ELECTRIC ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc SAFETY INSPECTION ---------------------------------------------------------------------------- Owner Contractor - ------------------------ ----------------------- SHOUGH LISA R FERRANTI ' S ELECTRIC 61 BEACH COTTAGE LANE 1697 IVEY ROAD ATLANTIC BEACH FL 322331986 GREEN COVE SPRINGS FL 32043 (904) 529-7422 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL PERMIT Additional desc . . Permit Fee . . . . 90 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 12/02/12 ---------------------------------------------------------------------------- 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: RJ---AC t4 r—a7- 6i �AiyL% PERMIT# JEA INFORMATION REQUIRED ON ALL PERMITS 0 AMPS �_4 l Q VOLTS PHASE VALUE OF WORK$ NEW SERVICE ❑ Overhead ❑ Underground ❑T Underground up Pole ❑Residential(Main) Service ❑0-100 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 7L0-100 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 ❑CT Service amps ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC. Outlets/Switches: 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$ REPAIItS/MISCELLANEOUS ❑Replace Burnt/Damaged Meter Can Xafety Inspection El Panel Change 11 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 J c, Phone Number Aa L/ - 9 9 6 n Electrical Company C L(' Office Phone S4S-Roti 1 Fax S). L/2_), Co.Address: ! 4 .Zvr�, R v� City �/Ec,�; el.,,���jpr, tate�(Zip 3t License Holder (Print): State Certification/Registration# �6�6 Notarize u C . MY CUMMIBEIid q w d subscribed befo .. . EXPlREB;MA9bl an — �. 9ondey 7hty Nolay p u�fivll_ _ . ature of Notary Publi ti � .5- 30dd