1915 Creekside Cir 2012 elec " CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
' ATLANTIC BEACH, FL 32233
1 INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-0001127 Date 8/29/12
Property Address . . . . . . 191E CREEKSIDE CIR
Application type description ELECTRIC ONLY
Property Zoning . . . . . . . TO EE UPDATED
Application valuation . . . . 985
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Application desc
change out 200 amp panel
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Owner Contractor
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MADDY JERALD D & SALLY C AMERICAN ELECTRICAL CONTRACTOR
1915 CREEKSIDE CIRCLE 5065 ST. AUGUSTINE RD #13
ATLANTIC BEACH FL 322334505 JACKSONVILLE FL 32207
(904) 737-7770
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Permit . . . . . . ELECTRICAL PERMIT
Additional desc . . CHANGE OUT 200 AMP PANEL
Permit Fee . . . . 90 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 2/25/13
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Other Fees . . . . . . . . . STA7E ELEC DCA SURCHARGE 2 . 00
STATP 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
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PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OFA LANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
i
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic',Beach, FL 32233
Ph (904) 247-5826 Fax x(904) 247-5845
.TOB ADDRESS: Z�2Xt PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS Z PS VA�3)OLTS PHASE
VALUE OF WO $
NEW SERVICE ❑ Overhead ❑ Underground ❑T Underground up Pole
l Residential(Main) Service
0-100 amps , 101-150amps i 1151-200amps amps #of Meters
Commercial(Main) Service
10-100 amps C 101-150amps _I 151-200amps amps 1 CT Service amps
Conductor Type Size
1Multi-Family((Main) Service E
0-100 amps ❑101-150amps 1151-200amps amps #of Unit Meters
]Temporary Pole amps
SERVICE UPGRADE amps i CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
1100 amps 1150amps 11200amps I 1 amps !CT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSO Y 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 F Sign ❑Smoke Detectors_Qty 7ranslbrmers KVA I Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans & Fire Alarm Checklist)
Qty volts/amps VALUE OF WORK$
EPA
IRS/MISCELLANEOUS
Replace Burnt/Damaged Meter Can 1-I Safety in ion I Panel ange l 'OH to UG
_ Other: 00 0
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 an I 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"Nam —':ZYY) 11!- Phone Number (p
Electrical Compa Office one
Co. Addres US %7 E' ✓ Ci State Zi12%�7 '
License Holder (Print): Ce ification/Registration#
Notarized Signature•of.Lioe Neflolder At
...ANNA Ma DP'Y ��}
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••"" ��g5b314 Sworn and subscribed before a is— da f 20�
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aT Py Purr x EXplrea 11251201
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� .,mc Signature of NotaryPublic
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