1848 Forsyth CT 2012 elec service (new) . ?S!.•�`1 rjv� .
CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
J ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-00001606 Date 10/30/12
Property Address . . . . . . 1848 FORSYTH CT
Application type description ELECTRIC ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
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Application desc
new service
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Owner Contractor
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TOWERS VENITA D KNIGHT ELECTRIC LLC
1848 FORSYTH CT 910 11TH AVE S
ATLANTIC BEACH FL 32233 JAX BEACH FL 32250
(904) 247-9884
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Permit . . . . . . ELECTRICAL PERMIT
Additional desc . .
Permit Fee . . . . 125 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 4/28/13
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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 125 . 00 125 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 129 . 00 129 . 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: J` �' �'�Si C� PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS v?u) AMPS 211 o VOLTS l PHASE
VALUE OF WORK$
NEW SERVICE ❑ Overhead ❑ Underground ❑1 Underground up Pole
❑Residential(Main) Service
00-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Meters
❑Commercial(Main) Service
00-100 amps ❑101-150amps ❑151-200amps a amps OCT Service amps
Conductor Type Size
❑Multi-Family(Main)Service
00-100 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 Z00amps ❑ amps ❑CT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-3 Damps 31-l 00amps 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)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
❑Replace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change OOH 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 /r' 'S Phone Number
Electrical Company k�-�ti� Ltr(Tj?((-- LL(- OfficePhone 24/74YTT Fax
Co.Address: 7o 11 h. P 1'c City �` State R Zip
License Holder(Print): Aft IlAlr 'l State Certification/Registration #
Notarized Signature of1
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