1964 Brist De Mar 2014 Elec CITY OF ATLANTIC BEACH
s) 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
ELECTRICAL PERMIT INSPECTION PHONE LINE 247-5814
� ALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATI N:
Job -
Job Type: ELECTRIC ONLY
Description: 3 switches
Estimated Value:
Issue Date: 10/14/2014
Expiration Date: 4/12/2015
PROPERTY ADDRESS:
Address: 1964 BRISTA DE MAR CIR
RE Number: 169506-1692
PROPERTY OWNER:
Name: NEMECEK, FRED C
Address: 1964 BRISTA DE MAR CIR
GENERAL CONTRACTOR INFORMATION:
Name: RIVER CITY ELECTRIC
Address:
Phone• - -
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Switch Outlets $1.80
Trade Permit Base Fee $55.00
Total Payments: $60.80
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL-32233
Ph(904) 247-5826 Fax (904) 247-5845
JOB ADDRESS: kq (,`A `� � �q C- . PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS AMPS VOLTS PHASE
VALUE OF WORK$
NEW SERVICE ❑ Overhead ❑ Underground ❑T Underground up Pole
❑Residential(Main) Service
❑0-100 amps ❑101-150amps ❑151-200amps El-amps #of Meters
❑Commercial(Main) Service
00-100 amps ❑101-150amps ❑151-200amps ❑ amps ❑CT Service amps
Conductor Type Size
❑Multi-Family(Main)Service
110-100 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
❑Replace Burnt/Damaged Meter Can ❑Safety Inspection El Panel Change DOH to UG
her: D,-_X �` j i-tLI-04S. O t 0 v
Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months. I here y 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 Q�V�C� � ` L Office Phone 591 _O��S Fax
Co.Address: City orStateVL Zip 3 2,-)_77>
License Holder(Print): _�State Certification/Registration
Notarized Signature of License Holder
Befor m this N day of20 1
E
Notary Public Stete of Florida ignature of Notary PublicKitty Cook
My Commission EE148663xpires 01/15/2016
A_