610 Ocean Blvd 2013 elec for ac �r i II
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
Application Number . . . . . 13-00002409 Date 4/02/13
Property Address . . . . . . 610 OCEAN BLVD
Application type description ELECTRIC ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
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Application de c
CIRCUIT FOR A
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Owner Contractor
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SKINNER, C B JR C & R ELECTRICAL SERVICES, INC
78 SAN JUAN DR 5368 MUSCOVY ROAD
PONTE VEDRA BEACH FL 32082 MIDDLEBURG FL 32068
(904) 291-9436
Permit ELECTRICAL PERMIT
Additional des . .
Permit Fee . . 65 . 00 Plan Check Fee . 00
Issue Date Valuation . . . . 0
Expiration Date 9/29/13
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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
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Permit Fee Total 65 . 00 65 . 00 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Tot 1 4 . 00 4 . 00 . 00 . 00
Grand Total 69 . 00 69 . 00 . 00 . 00
PERMIT IS APPROVED ONLY IN A CORDANCE 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: PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS 476 AMPS 24t0�?r VOLTS PHASE
VALUE OF WORK$
NEW SERVICE ❑ Overhead ❑ Underground EDUnderground up Pole
❑Residential(Main) Service
❑0-100 amps ❑101-1 50amps ❑l 51-200amps ❑ amps #of Meters
F.Commercial(Main)Service
LO-100 amps ❑101-150 mps ❑151-200amps ❑ amps OCT Service amps
Conductor Type Size
E Multi-Family(Main) Service
❑0-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Unit Meters
❑Temporary Pole ❑ - amps
SERVICE UPGRADE []--amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACC SSORY STRUCTURES,ETC.)
❑100 amps ❑150amps 0200amps ❑ amps OCT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-30 mps 31-100amps 101-200amps
Appliances: 0-3 amps �_31-100amps 101-200amps
A/C Circuits: 0-6 amps 61-100amps
Heat Circuits: # circuits C6'-
Number
Number of Lighting Outlets, Ir eluding Fixtures:
OTHER ELECTRICAL PROJECT
❑Swimming Pool ❑ Sign ❑Smoke Detectors_Qty ❑Tra sformers KVA ❑Motors hp
FIRE ALARM SYSTEM (Requires sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
❑Replace Burnt/Dam/aged Meter Can ❑Safety Inspection ❑ anel Change 0O to UG
i�ther: !/ S.Xal IAIOI-c Ze
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 Phone Number
_ RAY o`o�
Electrical Company Office Pho e Z9/ 1 K76 Fax Z?/-S'Y77
Co. Address: w Gk4 City State H Zip LZ&&
License Holder(Print): L Stat Certification/Registration# e,-e-
Notarized Signature of License Ho.der
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SHRLEIL.G - me this_�day o i 0 ,13
My COR•M:5')1Od 4 DD 95M,10
' t EXPIRES:Feeruary 14, ri e of Notary Public
%dpi 011 Bonded Thm Notary Public,underwriters