306 12TH ST UG ELEC SVC If SS\ CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 14-ELEC-516
Job Type: ELECTRIC ONLY
Description: NEW UG 400AMP 240VOLTS 1 PHASE
Estimated Value:
Issue Date: 11/26/2014
Expiration Date: 5/25/2015
PROPERTY ADDRESS:
Address: 306 12TH ST
RE Number: 171923-0000
PROPERTY OWNER:
Name: TOUSEY JR, CLAY B & PHYLLIS,
Address: 2225 ALICIA LN
GENERAL CONTRACTOR INFORMATION:
Name: LORE ELECTRICAL CONTRACTORS
Address: 21ONROSCOEBLVD QA MICHAEL LEE LORE
Phone:
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Electrical Primary Service $50.00
Total Payments: $109.00
1
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach, Fl, 32233 A/
Ph(904) 7-5826 Fax (904) 247-5845
JOB ADDRESS: PERMIT#
I
JEA INFORMATION REQUIRED ON ALL PERMITS 1�60 AMPS ?,Wd VOLTS PHASE
VALUE OF WORK$ 2-6 ,O-Z-D
NEW SERVICE F-1 Overhead ED/Underground D Underground up Pole
EIResidential(Main) Service
El)-100 amps Ll 101-150amps 11 151-200amps E—amps #of Meters
ElCommercial(Main) Service
El)-100 amps 1110 1-15 Oamps 11 151-200amps 0—amps E CT Service amps
Conductor Type Size
LiMulti-Falmily(Main)Service
-100 amps El 10 1-1 50amps El 151-200amps El .....amps # of Unit Meters
niporary Pole 11_jj�amps
SERVIC K UPGRADE E __.amps 11 CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
L1100amps E1150amps 0200amps Ll amps EICT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Out ets/Switches: 0-30amps 3 1-1 00amps 101-200amps
Ap liances: 0-30amps 31-100amps 101-200amps
A/ Circuits: 0-60amps 61-100amps
Heat, Circuits: # circuits @__kw
Number of Lighting Outlets, Including Fixtures:
I
OTHER ELECTRICAL PROJECTS
E Swimming Pool El Sign 0 Smoke Detectors_Qty 11 Transformers KVA []Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty—volts/amps VALUE OF WORK$
REPAIRSIMISCELLANEOUS
EReplace Burnt/Damaged Meter Can 0 Safety Inspection 0 Panel Change Li OH to UG
Ll Other:
Permit becoi nes void if work does not commence within a six month period or work is suspended or abandoned f6r 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 iot. 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 wners Nam
, 4 Phone Number
Electrical Company t_1
6&1;:�'yl G�h. J-7xe L Office Phone �-?3-11V_? —Fax
0 7 0� , -
pot r C-- 15( city State ip 2.-
Co.Address:
License'H Ider (Print): Stl ication/Registration#
,/Certif
Notarize�Signature of License Holder
.z EXPIRES:Ap 24,2017 Signature of Notary Pub
JENNIFER WALKER Before me this aV45��0 20
ON#FF 011480
Eionded Thru Notary Public Underwriters
MY comkilssl
lic