122 & 128 Pine St 2014 panel chg CITY OF ATLANTIC BEACH
ij 800 SEMINOLE ROAD
J � ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
14-00001401 Date 8/26/14
Application Number 128 PINE ST
Property Address • • • ' ' • 122 AND 128
Tenant nbr, name . . . . .
Application type description ELECTRIC ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . • 0
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Application desc
PANEL CHANGE 100AMP 230 VOLTS 1PHASE ---------------- ------
-----------------------------------------------------
Contractor
Owner
------------------------ ------------------------
HENRY, KATHLEEN ROSS MCCLURE ELECTRICAL CONTRACTORS
12906 BIGGIN CHURCH RD S 537 5TH AVENUE N
JACKSONVILLE FL 32224 JACKSONVILLE BEACH FL 32250
(904) 237-4701
------
Permit
• ELECTRICAL PERMIT
Additional desc . Plan Check Fee . 00
Permit Fee . . . . 90 . 00 Valuation • 0
Issue Date . . . .
Expiration Date 2/22/15
2 . 00
Other Fees STATE ELEC DCA SURCHARGE
• - _ STATE ELEC DBPR SURCHARGE
------
2_00-----
---------------------------------------Paid------Credited
Due
Fee summary Charged
Permit Fee Total 90 . 00 90 . 00 . 00
. 00
Plan Check Total 00 4 . 00 .. 00 . 0000 . 00
Other Fee Total 4 . 00 00 . 00
Grand Total 94 . 00 94 . 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
.TOB ADDRESS: �Z �t`�' � S� ' PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS t oo AMPS f-10 VOLTS
PHASE
VALUE OF WORK$ 'T O�D `'o
NEW SERVICE ❑ Overhead ❑ Underground ❑T Underground up Pole
❑Residential(Main)Service s #of Meters
00-100 amps O101-150amps ❑151-200amps -1 --amps
❑Commercial(Main)Service
00-100 amps ❑101-150amps ❑151-200amps n amps OCT Service amps
Conductor Type Size
❑Multi-Family(Main)Service
00-100 amps ❑101-150amps n 151-200amps []_______amps # of Unit Meters
❑Temporary Pole ❑ amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps CI 150amps 0200amps ❑ amps OCT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,2ETC. s
31-l 00am
Outlets/Switches: 0-3 Camps p101-101
Appliances: 0-30amps Ps
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 _KV A ❑Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans) VALUE OF WORK$
Qty volts/amps
PAIItS/MISCELLAN US
rn amaged Meter Can ❑Safety Inspection anel Change DOH 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.
Phc1�e Number
Property Owners Name
Electrical Company
�� L�� \e_ c C ru` Office Plicrue 2SI—4?.e 1 Fax
City ;ASA & State ift- Zip 3 2 ZSR
Co.Address:
tiL al?, State CeI tication/R atio �F-00.0a% 8
License Holder(Print):
Notarized Signature of License Holder L"L�
efore me thi a o 2
y JENNIFERWALKER
,• �y My COMMISSION Y FF 011480
EXPIRES:Apel 24,2017 Signature of Notary Public
Bonded Shru Notary
Public underwrders