475 Palmwood Ln 2014 plumb CITY OF ATLANTIC BEACH
s f 800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
r Js31�•
Application Number . . . 14-00000364 Date 3/11/14
Property Address . . . . . . 475 PALMWOOD LN
Application type description ELECTRIC ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
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Application desc
10 fixtures
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Owner Contractor
-
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NELLIS RICHARD E MOORE ELECTRICAL CONT. , INC.
475 PALMWOOD LANE 10526 CRAIG INDUSTRIAL DR
ATLANTIC BEACH FL 322335607 PO BOX 350579 JAX 32235
JACKSONVILLE FL 32225
(904) 645-6807
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Permit . . . . . . ELECTRICAL PERMIT
Additional desc .
Permit Fee 64 . 80 Plan Check Fee . 00
Issue Date . . . Valuation 0
Expiration Date . . 9/07/14
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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 64 . 80 64 . 80 . 00 . 00
Plan Check Total . 00 . 00 . 00 . 00
Other Fee Total 4 . 00 4 . 00 . 00 . 00
Grand Total 68 . 80 68 . 80 . 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
`l Ph(904) 247-5826 Fax (904) 247-5845
JOB ADDRESS: /`�y� Oof won 4/ 4t/� PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS _AMPS aYD VOLTS / PHASE
VALUE OF WORK$_,/
SOD. *o
NEW SERVICE ❑ Overhead ❑ Underground ❑T Underground up Pole
❑Residential (Main) Service
❑0-100 amps ❑101-150amps ❑151-200amps ❑ amps # of Meters
❑Commercial(Main) Service
00-100 amps 0101-150amps 0151-200amps ❑ amps CCT Service amps
Conductor Type Size
❑Multi-Family(Main)Service
❑0-100 amps ❑101-150amps ❑151-200amps ❑ amps # of Unit Meters
El Temporary Pole ❑ amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps ❑150amps 0200amps ❑ amps ECT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: _0-30amps 31-100amps 101-200amps
Appliances: / 0-30amps 31-100amps 101-200amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures: In
OTHER ELECTRICAL PROJECTS
❑Swimming Pool ❑ Sign ❑Smoke Detectors_Qty ❑Transformers KVA []Motors-hp
FIRE ALARM SYSTEM (Requires 3 sets of plans&Fire Alarm Checklist) VALUE OF WORK$
Qty volts/amps
REPAIRS/MISCELLANEOUS
❑Replace Burnt/Damaged Meter Can El Safety Inspection El Panel Change ❑OH to UG
L ,Z :.� /o rocs d
❑Other: �¢ ,d
If onth period or work is suspended or abandoned for six months. I hereby certify that I have
Permit becomes void if work does not commence within a six m
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 /vG %s Phone Number
,� � LL / fice PhonFax
e�JOY�
/�& CYS'+���/' pa 'Gyf��J'7
Electrical Company / ore /"�O.�TY %CB/ .�/t'A Of
Co. Address:
PD A ccity e7oC State Zip,Ems
License Holder (Print): A/ /'+L State Certification/Registration 4 F�ODD/7�Jd
Not e 4-71a t�4Kd �48NF�A >
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Notary Public-State of Florida �day of 20
•E My Comm.Expires Aug 25.2S d sub ribed fore e this
;91 P Commission# EE 21076
Bonded Through National Notary AgP ature of Notary Public