2050 BEACH AVE ELEC IS CITY OF ATLANTIC BEACH
' ` za 800 SEMINOLE ROAD
j 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-672
.lob Type: ELECTRIC ONLY
Description: SWIMMING POOL
Estimated Value:
Issue Date: 12/17/2014
Expiration Date: 6/15/2015
PROPERTY ADDRESS:
Address: 2050 BEACH AVE
RE Number: 169712-0000
PROPERTY OWNER:
Name: CDL AB LLC
Address: 335 11TH ST
GENERAL CONTRACTOR INFORMATION:
Name: HAZOURI ELECTRIC, INC.
Address: P O BOX 56559 QA ROBERT HAZOURI
Phone: - -
FEES:
Swimming Pools $40.00
State Elec DCA Surcharge $2.00
Trade Permit Base Fee $55.00
State Elec DBPR Surcharge $2.00
Total Payments: $99.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach, FL 32233
Ph(904)247-5826 Fax (904) 247-5845
JOB ADDRESS:
5� -e (A C,� /� V * — PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS AMPS VOLTS PHASE
VALUE OF WORK$
NEW SERVICE ❑ Overhead ❑ Underground ❑1 Underground up Pole
[]Residential(Main) Service
❑0-100 amps ❑101-150amps ❑151-200amps []—amps #of Meters
❑Commercial(Main) Service
❑0400 amps 11101-1 50amps ❑151-200amps ❑ amps ECT Service amps
Conductor Type Size
❑Multi-Family(Main)Service
1 0-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Unit Meters
❑Temporary Pole ❑ amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FE DER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑ 00 amps ❑150amps ❑200amps ❑ amps ❑CT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 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 Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
El Swimming Pool ❑ Sign [I 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 [I Panel Change ❑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 Namel Phone Number
Electricals',Company `1 �0 J �` Office Phone Z 1 j - Y/`p
Y(Fax
Co.Address: Z Of' r' l�t1 S '� City Statef Zip
License Holder (Print): li �!` �` �`�^�-`� '� State Certification/Registration# ('.0 0 0 3 7
Notarized Signature of License Holder
Before me this day of 20
Signature of Notary Public