Permit Elec 781 Camelia St 2012 CITY OF ATLANTIC BEACI
j 800 SEMINOLE ROAD
J w ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
JJI
Application Number . . . . . 12-00001730 Date 11/21/12
Property Address . . . . . . 781 CAMELIA ST
Application type description ELECTRIC ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
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Application desc
Reground Electrical Service
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Owner Contractor
------------------------ ------------------------
SCHRADER MATTHEW H AMERICAN ELECTRICAL CONTRACTOR
781 CAMELIA ST 5065 ST. AUGUSTINE RD #13
ATLANTIC BEACH FL 322332547 JACKSONVILLE FL 32207
(904) 737-7770
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Permit . . . . . . ELECTRICAL PERMIT
Additional desc . . REGROUND ELECTRICAL SERVICE
Permit Fee . . . . 90 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 5/20/13
----�------------------------------------------------------------------------
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 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 -7 D (��f mL��! G'L. ?`r��- PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS 4 5- MPS 2 VOLTS PHASE
VALUE OF WORK$
NEW SERVICE ❑ Overhead ❑ Underground ❑J Underground up Pole
Residential(Main) Service
107100 amps 1101-150amps 1151-200amps amps #of Meters
Commercial(Main) Service
0-;100 amps [1101-150amps 151-200amps amps CT Service amps
Conductor Type Size
Multi-Family(Main) Service
0-1100 amps 1101-150amps 151-200amps amps #of Unit Meters
1 Temporary Pole i I amps
SERVICE UPGRADE amps 1 CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
10.0 amps C1150amps 1200amps 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
Switnming Pool C Sign Smoke Detectors_Qty Transformers KVA 1Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans & Fire Alarm Checklist)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
Replace Burnt/Damaged Meter Can Safety Inspection Panel Change
Change OH to UG
Other: C (�tl r��� C�. �� ( � 1 �L�(/ ru l
Permit become$void if work does not commence within a six month period or work is suspended or abandoned for six months. I hereby certify that I have
read this application and know the same to be true and correct. All provisions of laws and ordinances governing this work will be complied with whether
specified or not; The permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of
construction.
� V -75
Property Owners Name t d E' -- Phone Number
Electrical Cqmpan
Co. Address:
License Holder (Print): ! to e fic tion/Registration # �
�o
Notarized SigllldJLur6• '�ictht5'�HolderIN
f............� I�NIA M.DAL..
..1��O1 Comm#�gy�1a 1 Sworn and subscribed befor m his aC> ay o �� 20 IZ
�%pir 115118
pip e N q :,ift Signature of Notary Public
e �+ ..��e�.,�,..n��sM11111111p11111
From:American Electrical Contract 9047371099 11/21/2012 10:22 #040 P.001/001
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
Ph (904) 247-5826 Fax (904) 247-5845
.TOB ADDRESS: 7?/ ���i`Ct~, J��"L�� �— PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS , MPS2�/l VOLTS _ PHASE
VALUE OF WORK$
NEW SERVICE ❑ Overhead ❑ Underground ❑1 Underground up Pole
Residential(Main)Service
10-100 amps 7101-150amps 151-200amps amps #of Meters
Commercial(Main)Service
0-100 amps '101-150amps -1151-200amps amps CT Service amps
Conductor Type Size
'Multi-Family(Main)Service
7'0-100 amps 1101-150amps 151-200amps amps #of Unit Meters
Temporary Pole i amps
SERVICE UPGRADE amps l CT Service amps
NEW FEJEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
100 amps 150amps 7200amps 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
Heaft 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$
REPAIRS/MISCELLANEOUS
Replace Burnt/Damaged Meter Can rSafety IInspectti`on Panel Change OH to UG
OtIer: 2- > r(.f) CiF Ae- '" r 1 (�ay j rU)l sc
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. . n -�
Property Owners Name PQ(�1 A` �h� e �— Phone Number V�<� -75
EIectrical Compan —LP/-/`(c� `� �l 'l y/� Office P nQ� "
Co.Addreis: ty State I'L Zip
License Holder (Print): -�. l to ectiific tion/Registration# LCA
Notarized'SiK jj�µre.,4 f&-e Holder
.�•au.n..huA M DAL.
a ' Commtl pg 4314 - Sworn and subscribed befor m his ay o � `n � 20 l�
6xyl 4D48
� +:1 Signature of Notary Public
g � i9t Neiaq
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