1021 Atlantic Blvd #1003 elec safety 2015 CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
J V ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
30B INFORMATION:
]ob ID: 15-ELEC-9
Job Type: ELECTRIC ONLY
Description: SAFETY INSPECTION
Estimated Value:
Issue Date: 1/6/2015
Expiration Date: 7/5/2015
PROPERTY ADDRESS:
Address: 1021 ATLANTIC BLVD
RE Number: 177602-0040
PROPERTY OWNER:
Name: EQUITY ONE ATLANTIC VILLAGE,
Address: 16 NE MIAMI GARDENS DR ATTN: TREASURY DEPT
GENERAL CONTRACTOR INFORMATION:
Name: ALLBRIGHT MANAGEMENT PROFESSIONALS INC
Address: 7818 Professional PL
Phone: - -
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Temporary Electrical Service $35.00
Total Payments: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION / O
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233 'v
3
Ph (904) 24n6 7-15826 Fax (n90Q4) 2j47- 845 � (J �
JOB ADD S: 0 L�/V�)C UD PERMIT#
JEA INF �OZ'REQUIRED ON ALL PERMITS - AMPS OLTS .S' PHASE
a
VALUE OF WORK$
NEW SERVICE ❑ Overhead Eg 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 LA 51-200amps amps CT Service amps
Conductor Type Size 3ho
Multi-Family (Main) Service
0-100 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: 0-30amps 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
Swimming Pool Sign Smoke Detectors_Qty Transformers KVA Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans) VALUE OF WORK$
Qty volts/amps
REPAIRS/MISCELLANEOUS
Replace Burnt/Damaged Meter Canafety Inspection 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. t ' I
Property Owners NameE0 1 — h e N���-V �/ Ohone Number
Electrical Company )M r`1
MAN e m e"-f rig Office Phone 1213-880-0-0C-) Fax8l3 X80 -03-3
Co. Address:t 1 7 r0 f ��� �l City )AM'Q& State-EL Zip 3 r
License Holder (Print): 1— l C r r—e IP State Certification/Registration# R,
Is
Notarized Signature of License Holder _
JOHN IMAM01A r
# * MY COMMISSION FF W4498 Sworn and subscribed before me day of •� 20�
EXPIRES:August 11,2017 Signature of Notary Public
k o*Pn k*NWy Services