1820 Mayport Rd #14 elec safety CITY OF ATLANTIC BEACH
s) 800 SEMINOLE ROAD
J ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 14-00000699 Date 5/02/14
Property Address . . . . . . 1820 MAYPORT RD 1
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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OSSI KLOTZ LLC VALDAN ELECTRIC CO.
338 19TH STREET
ATLANTIC BEACH FL 32233 ATLANTIC BEACH FL 32233
(904) 716-3626
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Permit . . . . . . ELECTRICAL PERMIT
Additional desc . .
Permit Fee . . . . 90 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 10/29/14
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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
800 Seminole Rd, Atlantic Beach,FL 32233
Ph(904) 247-5826 Fax(904)247-5845
JOB ADDRESS: ,G d PERMIT#
/ �
JEA INFORMATION REQUIRED ON ALL PERMITS —rr AMPS ;VO, VOLTS PHASE2_016 3
VAL UE OF WORK
NEW SERVICE ❑ Overhead ❑ Underground ❑T Underground up Pole
❑Residential(Main)Service s #of Meters
00-100 amps [110 1-15 0amps ❑151-200amps ❑ amp
❑Commercial(Main)Service s OCT Service amps
[10-100 amps ❑101-150amps ❑151-200amps ❑ P
Conductor Type Size
[I Multi-Family(Main)Service #of Unit Meters
[10-1000-100 amps ❑101-150amps ❑151-200amps ❑ amPs
[]Temporary Pole ❑ amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps ❑150amps 0200amps ❑ amps OCT 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
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) VAL UE OF WORK$
Qty volts/amps
REPAIRS/MISCELLANEOUS
❑Replace Burnt/Damaged Meter Can ZafetyInspection ❑Panel Change [I 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
J Fri /( Phone Number
/a / �X Oe (���� , Office Phone Fax
Electrical Company
Co.Address: 3 2
3 Vl �(`t�'� (C� � 1— City State ZiP
�
License Holder(Print): State Certification/Registration#
Notarized Signature of License Holder �
JENNIFERWALK , fore me this day of 20
A y MY COMMISSION P r 1
`�' ;- EXPIRES:April'�; ui7 Public
W. fAd' aonaea Thru ratan VW gllature of Notary —