1751 SEA OATS ELEC CITY OF ATLANTIC BEACH
Ys1
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-688
Job Type: ELECTRIC ONLY
Description: 45 OUTLETS
Estimated Value:
Issue Date: 12/19/2014
Expiration Date: 6/17/2015
PROPERTY ADDRESS:
Address: 1751 SEA OATS DR
RE Number: 172020-0444
PROPERTY OWNER:
Name: GROSS, JASON D
Address: 1751 SEA OATS DR
GENERAL CONTRACTOR INFORMATION:
Name: SEASIDE ELECTRICAL CONTRACTORS
Address: 12381 APPLE LEAF DR QA CLARK GEISSMAN
Phone: - -
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Switch Outlets $27.00
Trade Permit Base Fee $55.00
Total Payments: $86.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach, FL 32233
Ph(904)247-5826 Fax (904) 247-5845
JOB ADDRESS: A S J-eA 0^(< S �/� - PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS 2-OJ AMPS Z 0 VOLTS PHASE
VALUEOFWORK$ 30OD- '
NEW SERVICE ❑ Overhead ❑ Underground ❑T Underground up Pole
❑Residential(Main) Service
❑0-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Meters
❑Commercial(Main) Service
❑0-100 amps ❑101-150amps ❑151-200amps ❑ amps OCT Service amps
Conductor Type Size
[]Multi-Family(Main) Service
[10-100 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: q0-30amps 31-100amps 101-200amps
Appliances: 0-30amps 31-100amps 101-200amps
A/C Circuits: J 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 ❑Panel Change 11 OH 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.
Property Owners Name J S) C�/2c� S ! Phone Number
Electrical Company{S�/}S ,1Ne '�=�e�.{ �i c ,81 4ro,4tA-u 0M0ffice Phone S_1 Ll"o 15-3S Fax 6N2—3y!9
Co.Address: /2 6 20- 3 � ✓G- 13��� ?3 S City ' o v—u.e1(,eState tGG. Zip Y 2 2��
License Holder (Print): C1,�2<< ��� ` State Certification/Registration#L=/Z/3o 1351 S
e Holder
JENNIFER SVA':::. 20
MY COMMISSION 14 Before me this y of ��
a EXPIRES:Apfil
Bonded Thw Notft Public Uhc lry 95rs 11 CT
Signature of Notary Public