1633 BEACH AVE ELECTRIC 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-647
Job Type: ELECTRIC ONLY
Description: OH TO UG 200AMP 240 VOLT 1 PH
Estimated Value: VOLT EDGE ELECTRIC
Issue Date: 12/12/2014
Expiration Date: 6/10/2015
PROPERTY ADDRESS:
Address: 1633 BEACH AVE
RE Number: 169651-0000
PROPERTY OWNER:
Name: FARR, JAY AND MARY,
Address: 1633 BEACH AVE
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Electrical Service Change $50.00
Switch Outlets $31.20
Lighting Outlets, Including Fixtures $39.60
Trade Permit Base Fee $55.00
Total Payments: $179.80
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, Fl, 32233
Ph(904) 247-5826 Fax (904) 247-5845
JOB ADDRESS: A&L tlac'h --�-Zs5 Z PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS -2e22_AMPS VOLTS 51,jj&& PHASE
VALUE OF WORK$JEJ60
NEW SE -1 Overhead 5�'Underground Underground up Pole
=12 F
11 osd ntal(Main) Service #of Meters
1:10-100 amps 0 101-1 50amps 151-200amps El—amps
I]Cq'mmercial(Main)Service
110-100 amps 0101-150amps 11 151-200amps []_____amps [I CT Service amps
Cdnductor Type Size
[]Multi-Family(Main)Service
EO-100 amps 1110 1-I 50amps 11 151-200amps Fl—amps #of Unit Meters
0 Temporary Pole F1 amps
SERVICE UPGRADE amps 11 CT Service amps
NEW FEfDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
11 100 amps F1 150amps 0200amps E__ amps EICT Service amps
ADDITI�NS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: _5_0_0-30amps 31-100amps 101-200amps
Appliances: 0-30amps 31-100amps 101-200amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: # circuits @�kw
Number of Lightin s, Including Fixtures: 6/0
OTHER ELECTRICAL PROJECTS
11 Swimming Pool [I Sign E Smoke Detectors_Qty El Transformers KVA 11 Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty_volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
Li Replace Burnt/Damaged Meter Can 0 Safety Inspection El Panel Change V1<1t'0_UG
Ll 0 her:
Permit beco:nes 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 api lication 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. FU P-Z 6-0 - I -)--I -- 0
Property Owners Name <'kv Phone Number
Electrical Company 0 t Office Phone.'19y 50 77A'�Fax
- a w2l� 92en��c
Co.Address: City (11-ov State_ct zip -T.?&
State Certification/Registration# 1301 Y5 ZZ
License Holder(Print): 1)fnej Lgffl'y�y - -
</
Notarized Signature ofLicense Holder
I - �>r 20
JENNIFER WALKER Before me this
day of
MY COMMISSION 0 FF 0,i 1480
EXPIRES:APdI 24,2011 7 Signature of Notary Publi
Bonded Thru Notary Public Underwriters
8'.t" 11 Kj
EARLY POWER AGREEMENT & RELEASE
CITY OF ATLANTIC BEACH
Electric power is requested now under the conditions and terms of this fully executed Agreement&Release
Job Address:
;Y, & -3
Permit No. ot C,— �D L4 Service Type(Circle One): Overhead
We,the undersigned General Contractor and Electrician,understand and agree:
I. "Early Power" is purely for our construction convenience, it is not required by Codes and does not
substitute for Final Inspections or the C/O(Certificate of OccupancyTmat must be issued belbre occupancy,
and as such is at the discretion of the Building Official.
2. The City of Atlantic Beach will make a special inspection prior to the early power energizing. All rough
inspections must have prior Approval, including meter base connections.
3. Occupancy or use of the new construction before a formal C/O constitutes fraudulent use of the early
electric service. Such action is expressly prohibited and penalized by The City of Atlantic Beach
Ordinances. A violation of this Agreement shall result in a request for prompt removal of electric service
after a twenty-four hour notice.
4. "Early Power"release authority.is the Electrician and/or the Contractor and must not occur before:
a. Equipment,devices and fixtures are installed(or blanked off)safely.
b. Panel is complete with breakers and cover,and(labeling required at final inspection).
c. Service connection and grounding is complete.
d. The electric system has safely passed through electrical check.
e. Meter can is permanently mdrKed with address.
f. Temporary address numbers displayed(Permanent numbers are required for C/O).
5. This fully completed form is to be submitted to the Building Department by hand,mail or fax.
6. Future such Agreements will not be accepted from those who violate any one of the above items.
CONTRACTOR DATE
PRINT NAME
ELECTRICIAN DATE
PRINTNAME L
800 Seminole Road,Atlantic Beach FL 32233
Phone:(904)247-5826 Fax:(904)247-5845 http://www.coab.us revised 01 30 09