1767 W Park Ter 2014 elec `s 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-683
Job Type: ELECTRIC ONLY
Description: SWITCHES
Estimated Value:
Issue Date: 12/19/2014
Expiration Date: 6/17/2015
PROPERTY ADDRESS:
Address: 1767 W PARK TER
RE Number: 172020-0380
PROPERTY OWNER:
Name: PACE, JOHN PARK & ELAINE,
Address: 3380 PLAZA WAY
GENERAL CONTRACTOR INFORMATION:
Name: PAULA. O'QUINN INC.
Address: P O BOX 60185 QA PAUL A O'QUINN
Phone: - -
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Lighting Outlets, Including Fixtures $0.60
Trade Permit Base Fee $55.00
Total Payments: $59.60
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
Ph 904) 247-5826 Fax (904) 247-5845
.TOB ADDRESS: �p � -�(�/ PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS AMPS OLTS ' PHASE
VALUE OF WORK$
NEW SERVICE ❑ Overhead ❑ Underground 0 Underground up Pole
❑Residential(Main) Service
00-100 amps 11101-1 50amps ❑151-200amps ❑ amps #of Meters
❑Commercial(Main)Service
00-100 amps 11101-150amps ❑151-200amps ❑ amps OCT Service amps
Conductor Type Size
❑Multi-Family(Main)Service
00-100 amps 1110 1-15 Oamps ❑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)
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 Na Phone Number
%�--
Electrical Company. Office Phone � Fax
Co.Address: City State Zip
License Holder(Print): , State Certification/Registration# � f _
Notarized Signature of License Holder
Before me this day-of - 20
e�
Signature of Notary Public