1079 Atlantic Blvd # 4 safety elec 2012 CITY OF ATLANTIC BEACH
!, _ s 800 SEMINOLE ROAD
l. ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
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Application Number 12-00001809 Date 12/13/12
Property Address 1079 ATLANTIC BLVD
Tenant nbr, name UNIT 4
Application type description ELECTRIC ONLY
Property Zoning TO BE UPDATED
Application valuation . . . 0
Application desc
safety and add 1 circuit for sign
Owner Contractor
HARBOUR PLACE PROFESSIONAL RIVER CITY ELEC CONTRACTORS
PARK COMPANY 12496 GATELY OAKS LN E
13133 PROFESSIONAL DR STE 100 JACKSONVILLE FL 32225
JACKSONVILLE FL 32225 (904) 220-8216
Permit ELECTRICAL PERMIT
Additional desc .
Permit Fee . . . 90 . 00 Plan Check Fee . . . 00
Issue Date . . . Valuation . . . . 0
Expiration Date . 6/11/13
Other Fees STATE ELEC DCA SURCHARGE 2 . 00
STATE 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
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
4 CITY OF ATLANTIC BEACH
0 80 Seminole Rd, Atlantic Beach, FL 32233 Qh
i) / Ph(904) 247-5826 Fax (904) 247-5845 _ -, 011
JOB ADDRESS: /0 7 [ (,)11,y PERMIT# f
JEA INFORMATION REQUIRED ON ALL PERMITS /00 AMPS 01/0 VOLTS / PHASE
VALUE OF WORK$
NEW SERVICE ❑ Overhead i Underground U Underground up Pole
❑Residential(Main) Service
-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Meters
Commercial(Main) Service
.6=100 amps ❑101-150amps ❑151-200amps ❑ amps ❑CT Service amps
Conductor Type Size
▪Multi-Family(Main)Service
10-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Unit Meters
(Temporary Pole C amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
[1100 amps ❑150amps ❑200amps ❑ 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
1-i Swimming Pool ❑ Sign ❑Smoke Detectors_Qty El Transformers KVA ❑Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans) �d co
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS � '
I
'i
❑Replace Burnt/Damaged Meter Canafety Inspection ❑Panel Change CO H to UG
n I
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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 o the performance of
construction. r
O
Property Owners Name � so,g.-e_S 5 Phone Number Electrical Company gt` er.. C. L----7/07_'_
�-07 fig/mil, Office Phone Foy e 38 ax
Co. Address: Pe go x_ 35 /63 City uV State Zip 3 ZZ25
License Holder (Print): St, ;i«-`r�5 ,e__•cObo State ertiication/Registration# &/R/30/4cl?z-
Notarized ..-.. -...•-.�_� • _ Z. ,
^"a°;;•• SHIRLEY L.GRAHAM
. :% �� day o`aI_�`C• 120 12-
so: . ,z P,AY COMMISSION DC 9 Or 1 tills y ,
'.-���'.,.:�;= EXPIRES:February 14,2014 I ��1 �
r,' Bonded Thru Notary Public und,,'i'r, ure of Notary Public �L)
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