1580 BEACH AVE ELECTRIC CITY OF ATLANTIC BEACH
s 800 SEMINOLE ROAD
U =" ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
rv,Jl3 c)r�'
Application Number . . . . . 14-00000936 Date 6/11/14
Property Address . . . . . . 1580 BEACH AVE
Application type description ELECTRIC ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 0
----------------------------------------------------------------------------
Application desc
OH TO UG
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
KOHL, MARK UNITED ELECTRIC COMPANY OF
1580 BEACH AVENUE JACKSONVILLE
ATLANTIC BEACH FL 32233 5716 ST. AUGUSTINE ROAD
JACKSONVILLE FL 32207
(904) 731-4210
----------------------------------------------------------------------------
Permit . . . . . . ELECTRICAL PERMIT
Additional desc . .
Permit Fee . . . . 90 . 00 Plan Check Fee . 00
Issue Date . . . . Valuation . . . . 0
Expiration Date . . 12/08/14
----------------------------------------------------------------------------
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 AL1, 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: � rJ 0 �>C a C 4 vL PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS -�2 Of AMPS V'9 VOLTS PHASE
,VALUE OF WORK$
NEW SERVICE ❑ Overhead ❑ Underground ❑T Underground up Pole
❑Residential (Main) Service
00-100 amps ❑101-150amps ❑151-200amps ❑ amps # of Meters
❑Commercial(Main)Service
❑0-100 amps ❑101-150amps ❑151-200amps ❑ amps ❑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 ❑ 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 11 Smoke Detectors_Qty ❑Transformers KVA ❑Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans&Fire Alarm Checklist)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
❑Replace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change XOH 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. V 1
Property Owners Name a(lL 1K o 11� Phone Number 63/ - Y S F 7
Electrical Company U n I.+t) & o 361� Office Phone-13 1 - y Z 1 ° Fax -13) •531 l
Co.Address: 5-71t, S f, v �r-.� 112 City C JCS o�ur"f 1 L State rl- Zip
License Holder(Print): State Certification/Registration# 15C 6005361
Notarized Signature of License Holder )C
Sworn and subscribed before me this �"� day of 3 20 j q
Fil
RENDA K.Gl',IFl�1I Yco al.s!sslor uFsio%%s3PSignature of Notary Public
t� xxr!!zFs:apu 23,201; ,