378 SARGO RD ELEC SERVICE UPGRADE 2012 Y CIT1 OF ATLANTIC BEACH
N) k 800 SEMINOLE ROAD
,x �* ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-0001332 Date 9/14/12
Property Address . . . . . . 3781SARGO RD
Application type description ELE TRIC ONLY
Property Zoning . . . . . . . TO EJE UPDATED
Application valuation . . . . 0
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Application desc
SERVICE UPGRADE FROM 100 AMPS TO 200 AMPS
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Owner Contractor
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DONOR, JOSE P JR R & R ELECTRIC COMPANY
OW LORI D SANDERS P.O. BOX 60665
12603 FISH HAWK LANE JACKSONVILLE FL 32236
JACKSONVILLE FL 32225 (904) 768-6166
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Permit . . . . . . ELECTRICAL PE IT
Additional desc !
Permit Fee . . . . 105 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date 3/13/13
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Other Fees . . . . . . . STAiE ELEC DCA SURCHARGE 2 . 00
STATIE ELEC DBPR SURCHARGE 2 . 00
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Fee summary Charged Laid Credited Due
Permit Fee Total 105 . 00 105 . 00 ------- - 00 ------- - 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 109 . 00 109 . 00 . 00 . 00
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PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF Al LANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
P�P GG
ELECTRICAL PERMITT; E_AC_H
LICATION
CITY OF ATLANTIC --.r
800 Seminole Rd, Atlantic ;each,FL 32233
Ph(904)247-5826 Fax(c'104)247-5845
.TOB ADDRESS: PERMIT#
NEW SERVICE ❑Overhead ❑ Underground Underground up Pole Fro
❑Residential (Main) Service
❑0-100 amps ❑101-150amps ❑151-200amps ❑ amps # of Meters
[]Commercial (Main) Service
00-100 amps ❑101-150amps ❑151-200amps ❑ amps El CT Service amps
Conductor Type Size
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❑Multi-Family(Main) Service
00-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Unit Meters
El Temporary Pole ❑ temps `/ L j 12p1 Z0
SERVICE UPGRADE . _, . amps ❑ CT Seryce amps /
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES, TC.)
100 amps ❑150amps 0200amps ❑ amps ❑CT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCE44 SORY STRUCTURES,ETC.
Outlets/Switches: 0-30amps 31-100amps 101-200amps
Appliances: 0-30amps 31-100amps 101-200amps
A/C Circuits: 1 0-60amps 61-10Qamps
Heat Circuits: I # circuits @ S kw
Number of Lighting Outlets, Including Fixtures:
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OTHER ELECTRICAL PROJECTS
❑Swimming Pool ❑ Sign ❑Smoke Detectors Qty 0Tansformers KVA ❑Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans & Fire Ala Checklist)
Qty volts/amps VALUE OF WORK$
REPAIRS/1%,HSCELLANEOUS
❑Replace Burnt/Damaged Meter Can ❑Safety Inspectioi L ❑Panel Change ❑OH to UG
❑other:
Permit becomes void if work does not commence within a six month period or work is sus ended 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 jordinances governing this work will be complied with whether
specified or not. The permit does not give authority to violate the provisions of any other:
construction, tate or local law regulation construction or the performance of
2,
Property Owners Name 1V\ Y Phone Number
Electrical Company \ % WAOffice Phone 1 Fax �-`�C
i `
Co.Address: _k) � ��)\4\O�j City a R( ! ,VJIN`1 C State Zip
License Holder(Print): Stat Certification/Registration# C_C\1�3\s _
Notarized Signature of License Holder G�
�a .R::'�� KATHI,LMISIEY Sworn and subscribed before m this I�` day ofAWfj�f>►J 20�
# * MEXPIRES:!ma 2EE198478 Signature of Notary Public
Sy 20,2018
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