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185 Pine St 2013 safety inspection t �Ly �S r tju� CITY OF ATLANTIC BEACH, 1 j 800 SEMINOLE ROAD ATLANTIC BEACH, FL 32233 �. � INSPECTION PHONE LINE 247-5814 rR Application Number . . . . . 13-00003498 Date 10/04/13 Property Address . . . . . . 185 PINE ST Application type description ELECTRIC ONLY Property Zoning . . . . . . . TO BE UPDATED Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc SAFETY INSPECTION ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ MITCHELSON THEO K III ELITE ELECTRICAL SERVICES LLC 185 PINE ST 11611 CAPE HORN AVE ATLANTIC BEACH FL 322334011 JACKSONVILLE FL 32246 (904) 353-0190 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL PERMIT Additional desc . . Permit Fee . . . . 90 . 00 Plan Check Fee . 00 Issue Date . . . . Valuation . . . . 0 Expiration Date . . 4/02/14 ---------------------------------------------------------------------------- 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 CITY OF ATLANTIC BEACH 800 Seminole Rd,Atlantic Beach, FL 32233 Ph(904)247-5826 Fax(904)247-5845 JOB ADDRESS: �� PERMIT# JEA INFORMATION QUIRED ON ALL PERMITS � AMPS L�VOLTS PHASE VALUE OF WORK$ NEW SERVICE Overhead ❑ Underground ❑T 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 [I CT Service amps Conductor Type Size ❑Multi-Family(Main)Service 00-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Unit Meters []Temporary Pole ❑ amps SERVICE UPGRADE El-amps ❑ CT Service amps NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.) ❑100 amps ❑150amps 11200amps ❑ amps [ICT Service amps ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC. Outlets/Switches: 0-3 Damps 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 ❑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 []Panel Change ❑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 cal law regulation construction or the performance of construction. Property Owners Name 16e Ae Phone Number Electrical Company s / �t �� L ffice Phone Tsx y�a Fax Co.Address: IN7 ��� City_7A'1_r State f G Zip License Holder (Print): d Atate rtific 'on/Registration# Notarized Signature of License Holder Before me this day of 20 Signature of Notary Public