1089 Atlantic Blvd # 16 elec safety 1, CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
±� ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
CSA
Application Number . . . . . 14-00000532 Date 4/08/14
Property Address . . . . . . 1089 ATLANTIC BLVD
Tenant nbr, name . . . . . . UNIT 16
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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ASHLAND INVESTMENT, INC. KNIGHT ELECTRIC LLC
7880 GATE PARKWAY SUITE 300 908 11TH AVE S
JACKSONVILLE FL 32256 JACKSONVILLE BEACH FL 32250
(904) 247-9884
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Permit . . . . . . ELECTRICAL PERMIT
Additional desc . .
Permit Fee . . 90 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 10/05/14
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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
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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
J' �p Ph(9004) 247-5826 Fax(904) 247-5845
.TOB ADDRESS: {d 0 , 4r1'wl L pyct 1# PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS DO AMPS VOLTS PHASE
VALUE OF WORK$
NEW SERVICE Ce/Overhead ❑ Underground ❑T Underground up Pole
❑Residential(Main)Service
110-100 amps ❑101-150amps ❑151-200amps []_amps #of Meters
❑Commercial(Main)Service
00-100 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: 0-3 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 �
El Replace Burnt/Damaged Meter Can M! afety Inspection ❑Panel Change Ll 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 Phone Number
Electrical Company
L Office Phone Fax
IVf(� f�l�C CT ( �'` �D/�
h
Co.Address: �g !�� ACC S"
City Ji4- fles . State Zip
License Holder(Print): S-Tcor- 6m.(A f State Certification/Registration# &130/2-fV
Notarized Signature of License Holder a
Before me this day of 20
Signature of Notary Public