Permit Elec 1197 Mayport Rd 2012 C,
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-00001539 Date 10/19/12
Property Address . . . . . . 1197 MAYPORT RD
Application type description ELECTRIC ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
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Application desc
Safety Inspection 200AMP 120/240V 1Phase
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Owner Contractor
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SAFAR ANTON VALDAN ELECTRIC CO.
6949 LA LOMA DR 338 19TH STREET
JACKSONVILLE FL 322172668 ATLANTIC BEACH FL 32233
(904) 716-3626
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Permit . . . . . . ELECTRICAL PERMIT
Additional desc . . SAFETY INSPECTION
Permit Fee . . . . 90 . 00 Plan Check Fee . 00
Issue Date . . . . valuation . . . . 0
Expiration Date . . 4/17/13
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Other Fees . . . . . . . . . STATE ELEC DCA SURCHARGE 2 . 00
STATE ELEC DBPR SURCHARGE 2 . 00
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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 ALI., CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
11V Ph (904) 247-5826 Fax (904) 247-5845
JOB ADDRESS: PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS AMPS VOLTS PHASE
VALUE OF WORK$ 1),-5
NEW SERVICE F-1 Overhead Ej Underground Underground up Pole
Residential (Main) Service
110-100 amps 11 101-150amps I 151-200amps I amps of Meters
I Commercial(Main) Service
10-100 amps I �101-150amps I 151-200amps I i,_amps LiCT Service amps
Conductor Type Size
L Multi-Family(Main) Service
1-10-100 amps 1101-150amps 1151-200amps L_amps of Unit Meters
Temporary Pole L amps
SERVICE UPGRADE I �—amps I CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
11100amps F150amps I 1200amps � � amps CT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-30amps 3 1-1 00amps 101-200amps
Appliances: 0-30amps 3 1-1 00amps 101-200amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: # circuits @_kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
[:Swimming Pool I I Sign I i Smoke Detectors___Qty Transformers KVA F!Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans ,
Qty_volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
lReolace Burnt/Damaged Meter Can 14afety Inspection Panel Change �OH to UG
Other:
Permit becomcs 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 19-NIVI-) u"AM-0- Phone Number
- /'� -367-ff
16V 7
Electrical Company 041d'I'v '61,6C Office Phone Z Fax
Co.Address: J7'— City /-�QOA'State Zip 3""0
License Holder (Print (-2,jlb State Certification/Registration#//4-W Z-,i�70
A
Notarize r ftt e
S4. .4A
2015 '577"'rday of 20
May 21.
ExPiRES. nde n and subscribed be re thi
Bonded Thru Notary Pubhc U fo
Signature of Notary Public
_70 Y� 3 3 2- 0