623 Selva Lakes Cir 2014 elec t,. CITY OF ATLANTIC BEA
7 _ 800 SEMINOLE RX
;r ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 14-00000021 Date 1/17/14
Property Address . . . . . . 623 SELVA LAKES CIR
Application type description ELECTRIC ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
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Application desc
REGROUND ELECTRIC UNDERGROUND SVC 200AMP 240V 1PH
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Owner Contractor
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CORBITT, TERESA BOYKO AMERICAN ELECTRICAL CONTRACTOR
5065 ST. AUGUSTINE RD #13
623 SELVA LAKES CIRCLE
ATLANTIC BEACH FL 32233 (904)JACKS737-7FL 32207
770
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Permit . . . . . . ELECTRICAL PERMIT
Additional desc • Plan Check Fee . 00
Permit Fee . . . . 90 . 00 0
Issue Date Valuation
Expiration Date . . 7/16/14
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Other Fees
STATE ELEC DCA SURCHARGE 2 . 00
STATE ELEC DBPR SURCHARGE 2 . 00
_ ________ -----
Fee summary Charged
Paid Credited
. 00
_ _ ----------
----- ----------
- . 00
Permit Fee Total 90 . 00 90 . 00 00 . 00
Plan Check Total . 00 . 00
Other Fee Total 4 . 00 4 . 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
rr Ph (904) 247-5826 Fax (904) 247-5845-
ADDRESS: b a �el 1�(`. IR �� l i rC'a PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS 9 Uu AMPS VOLTS PHASE
VALUE OF WORK$
NEW SERVICE ❑ Overhead Underground ❑T Underground up Pole
residential(Main) Service
0-100 amps 101-150amps 1151-200amps amps #of Meters
Commercial(Main) Service
10-100 amps 101-150amps -151-200amps amps CT Service amps
Conductor Type Size
Multi-Family(Main) Service
10-100 amps ^1101-150amps I !151-200amps amps #of Unit Meters
Temporary Pole f amps
SERVICE UPGRADE amps CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
100 amps 150amps i 200amps amps l 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 !1 Sign iSmoke 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 Canll i11 Safety Inspection I Panel Change OH to UG
Other: e UlAh) C �4f,'LPA
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 df 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 �'�� �0l 64' ' Phone Number 0 -� �
P
Electrical Company I'1 (A 1Q /�`( � Offi P ne-737"777 /Fax
Co.Address:, .�' j ��nl°, /`-�r Ci StatdZlZip JF U/
Li a Holder (Print): Stat C cation/Registration#
N older
Notary P Stats of Florida J 20
. .
Anna M Sworn an subscribed bCoree this day oyi Q# 790 ��•o� iexPire.otnsr2o>t Signature of Notary Pub
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