119 Jasmine St 2013 safety elecCITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 13-00002973 Date 6/28/13
Property Address . . . . . . 119 JASMINE ST
Application type description ELECTRIC ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
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Application desc
SAFETY INSPECTION
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Owner
Contractor
--
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PENDERGRASS, THOMAS
W
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JAX ELECTRICAL CONTRACTING INC
87 W 3RD ST
1839 LANE AVE #100;
SUITE 110
ATLANTIC BEACH
FL 32233
JACKSONVILLE
FL 32210
(904) 483-8384
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Permit . . . . . .
ELECTRICAL
PERMIT
Additional desc . .
90.00
Plan Check Fee
.00
Permit Fee . . . .
0
Issue Date . . . .
Valuation . . .
.
Expiration Date . .
12/25/13
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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
----------
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
.TOB ADDRESS: 19 ., a S,m t, e SA, '32-2-33 PERMIT #
JEA INFORMATION REQUIRED ON ALL PERMITS 2- °y AMPS 2- " 0 VOLTS I PHASE
NEW SERVICE 2n Overhead
Residential (Main) Service
0-100 amps ❑ 101-150amps
Commercial (Main) Service
,0-100 amps ❑ 101-150amps
Conductor Type
"Multi -Family (Main) Service
[ .0-100 amps ❑ 101-150amps
Temporary Pole ❑ amps
VALUE OF WORKS 2-6o
❑ Underground ❑T Underground up Pole
❑ 151-200amps i_ i amps # of Meters
f._ 151-200amps jamps i j CT Service amps
Size
151-200amps ❑ amps
SERVICE UPGRADE ! amps 1 i CT Service amps
NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.)
100 amps ❑ 150amps 200amps Cl amps CT Service
# of Unit Meters
amps
ADDITIONS, REMODELS, REPAIRS, BUILD -OUTS, ACCESSORY STRUCTURES, ETC.
Outlets/Switches: 0-30amps 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 i 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 .i Panel Change I l OH 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 (or, er-/
6 Phone Number
Electrical Company �J_0_X cf e ct-11 « I r 6"��ac� Office Phone W3 � 3 � % Fax
Co. Address: l � 3 cI �ti e /tu 2 s, Sri! / / O City �1 ul' k(o n Lyd e State L Zip 3�z
License Holder (Print): —Pa.0 I State Certification/Registration # i�l��� y z31
N arabigna ~ciQ" o er
Notary Public - State of Florida
�_• •1 My Comm. Expires Jun 27, 201 fore me this day of JV ne 20 1:3
Commission #t EE 211793
4 ,
Otti �••`' Bonded through National Notary Assn. �gnature of Notary Public MA