78 W 4th St elec 2013 fire damage repairs CITY OF ATLANTIC BEACH
• , y 800 SEMINOLE ROAD
r3 ATLANTIC BEACH,FL 32233
J INSPECTION PHONE LINE 247-5814
�JFfl��
13-00002363 Date 4/12/13
Application Number 74 W 4TH ST
Property Address • • • • ' ' 78 W 4TH ST
Tenant nbr, name . . . . .
Application type description RESIDENTIAL ALTERATION
Property Zoning . . . . . . . TO BE UPDATED
Application valuation 16000
-------------------------
Application desc
FIRE DAMAGE REPAIRS
------------------------
Contractor
Owner
COX, RUSSELL AARON JONSSON CONSTRUCTION
14003 TOMAKA RD 333 SAN PABLO RD N FFL 32225 JACKSONVILLE L 32225
JACKSONVILLE
(904) 591-0599
--- Structure Information 000 000 FIRE DAMAGE REPAIRS
Occupancy Type . . . . . . RESIDENTIAL
----- ----
Permit ELECTRICAL PERMIT
Additional desc . . 1 OUTLET, 2 APPLC . 00
Permit Fee . . . . 57 . 60 Plan Check Fee 0
Valuation
Issue Date 10/09/13 _
Expiration Date ----
2 . 00
Other Fees
• STATE DCA SURCHARGE2 , 00
• STATE ELEC DCA SURCHARGE 2 , 00
STATE ELEC DBPR SURCHARGE 2 . 00
STATE DBPR SURCHARGE
------------------------ eCredited Due
Fee summary g ---------- ----
Chard Paid---
------------
---
-------
. 00
57 . 60 57 . 60
----------------- . 00
Permit Fee Total 00 60 00 . 00
Plan Check Total 8 . 00 00 . 00
Other Fee Total 8 . 00 65 . 60 65 . 60 00 . 00
Grand Total
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: 719 kles, `f n� . yneer'l PERMIT# /3-2343
,IEA INFORMATION REQUIRED ON ALL PERMITS /DD AMPS ?Vo VOLTS PHASE
VALUE OF WORKS zh&60
NEW SERVICE ❑ Overhead ❑ Underground ❑T Underground up Pole
❑Residential(Main) Service
U0-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Meters
rCommercial(Main) Service
u0-100 amps ❑101-150amps ❑151-200amps ❑ amps OCT Service amps
Conductor Type Size
GMulti-Family(Main)Service
00-100 amps ❑101-150amps (7151-200amps ❑ amps # of Unit Meters
OTemporary Pole ❑ amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps ❑150amps 0200amps ❑ amps OCT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 1 0-30amps 31-100amps 101-200amps
Appliances: 2 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
LSwimming Pool ❑ Sign ❑Smoke Detectors_Qty ❑Transformers KVA FJ Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORKS
REPAIRS/MISCELLANEOUS
❑Replace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change OOH to UG
ElOther:
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 6x, /�uss�s ro-r, / Phone Number 19D
Electrical Company � -+
&0m4 ' �e '� -'r �ii4t in Office Phone t9o4l) 7. BGo Fax '766• &Lz
Co.Address: 'lSZ3 Al 614, � `� City ✓A41ro"vlll State ,4'/ Zip e2%yo8
License Holder(Print): ja-wcs 44--,-e, State Certification/Registration# EQ 13OIZ744
Motarized Signature of License Holder
efore me is / I day of �� I 20 13
,�•!'�"�: JUDITH T. JOHNSON —
;'= MY COMMISSION*DD970523 Signature of Notary Public
EXPIRES March 14,2014
(I07)316-0153 RkidalloteryServlce.com