380 5th St 2013 low voltage . .:L`j-
CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
J ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 13-00003302 Date 8/22/13
Property Address . . . . . . 380 STH ST
Application type description ELECTRIC ONLY
Property Zoning . . . . . . . RES SF DISTRICT
Application valuation . . . . 0
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Application desc
low voltage
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Owner Contractor
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HILLIS KATHERINE ALLISON HALL ADT SECURITY SERVICES INC
380 5TH ST 7818 PHILLIPS HWAY BLDG 1
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32256
(904) 732-7748
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Permit . . . . . . ELECTRICAL PERMIT
Additional desc . .
Permit Fee . . . . 90 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 2/18/14
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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
(7O 800 Seminole Rd, Atlantic Beach, FL 32233
o Ph (904) 247-5826 Fax (9 4) 247-5845
JOB ADDRESS: -- (_4 (6V 1 G 0-01r^A PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS AMPS VOLTS PHASE
VALUE OF WORK$
NEW SERVICE ❑ Overhead ❑ Underground OT Underground up Pole
Residential (Main) Service
0-100 amps 101-150amps 151-200amps amps #of Meters
Commercial (Main) Service
0-100 amps 101-150amps 151-200amps amps CT Service amps
Conductor Type Size
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,ACCESSORY STRUCTURES,ETC.)
100 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
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 Safety Inspection Panel Change OH to UG
X Other: Installing low voltap_e security system 12 volts 2 amps 42goo
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 1 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 (�(JV� � Phone Number
Electrical Company ADT LLC Office Phone 904-732-7170 Fax 904-732-7760
Co.Address: 7818 Philips Hwy City Jacksonville State FL Zip 32256
License Holder (Print): State Certification/Registration# EF2000413
Notarized Signature of License Holder
yEfl
State of Florida Sworn and subscribed before me this 2 ay of -)o
�
ion EE 165279 Signature of Notary Public