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1820 MAYPORT RD #1 ELEC CITY OF ATLANTIC BEACH 800 SEMINOLE ROAD ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 Application Number . . . . . 14-00000699 Date 5/02/14 Property Address . . . . . . 1820 MAYPORT RD 1 Application type description ELECTRIC ONLY Property Zoning . . . . . . . TO BE UPDATED Application-valuation . . . . 0 - --------------------------------------------------------- --Application desc SAFETY INSPECTION Q ------------------ ------------------------------------------- (� Owner Contractor / ------------------------ ------------------------ OSSI KLOTZ LLC VALDAN ELECTRIC CO. 338 19TH STREET ATLANTIC BEACH FL Q ATLANTIC BEACH FL 32233 \ , ------------------------ Permit ! -----Permit ELEC' ICAL PERMIT Additional des Permit Fee . J.00 Plan Check Fee .00 Issue Date . . . . Valuation . . . . 0 Expiration Date . d/14 -------------------- ----------------------- l Other Fees . . . . . STATE ELEC DCA SURCHARGE 2.00 ----------------STATE-ELEC DBPR SURCHARGE 2_ ---- 00 -------------------- ------------ ------ Fee summary Charged ---Paid--- Credited - -Due- - Permit Fee Total 90.00 90.00 .00 .00 CX Plan Check Total .00 .00 .00 .00 / Other Fee Total 4.00 4.00 .00 .00 (� Grand Total 94.00 94.00 .00 .00 I00 J7 PERMIT IS APPROVED ONLY IN ACCORDANCE:WITI' .I,CITY OF ATLANTIC REACH ORDINANCES AND THE FLORIDA IIIJILDING CODES. t ELECTRIC.1 t PERMIT APPLICATION CITY c tF ATLANTIC BEACH 800 Seminol,Rd,Atlantic Beach,FL 32233 Ph(904)247-5826 Fax(904)247-5845 / PFRMIT# JOB ADDRESS: ` A /� ��f VOLTS PHASE �- AMPS ;k '? JEA INFORMATION REQUIRED ON ALL PERMITS �2 3 DQ I r.UE OF WORK S `� NEW SERVICE ❑ overhead ❑ Underground ❑l Underground up Pole Residential(Main)Service #of Meters 0-100 amps 101-150amps 151-200amps —amps Commercial(Main)Service CT Service amps 0-100 amps ;101-150amps t>i-200amps amps Conductor Type Size— Multi-Family(Main)Service s #of Unit Meters 0-100 amps 101-150amps t-200amps amps Temporary Pole amps SERVICE UPGRADE amps CT Service amps NEW FEEDER(ADDITIONS,ACCESSORY STRU(.-TURES,ETC.) -1CT Service amps 100 amps -150amps '200amps _ amps ADDITIONS,REMODELS,REPAIRS,BUILD-OIL,- S,ACCESSORY STRUCTURES,ETC' s outlets/Switches: 0-30amps 31-100amps 31-l OOam s 101-200amps Appliances: 0-30amps 61-100amp A/C Circuits: 0-60amps kw Ps Heat Circuits: #circuits @ Number of Lighting Outlets,including Fixtures: OTHER ELECTRICAL PROJECTS Transformers KVA Motors hp Swimming Pool Sign Smoke Detectors _Qty FIRE,ALARM SYSTEM (Requires 3 sets of pla►r+i VALUE OF WORK S Qty volts/amps Z, REPAIRS/MISCELLANEOUS , let Inspection Panel Change oil to UG xl Replace Bumt/Damaged Meter Can Y Pe i Other: f permit becomes void if work do10�es not commence within a six month period or work is suspended or abandoned for six months. 1 hereby certify that have read this application andthe does not give to au horny true d violate thet. provisions of any other stats of laws and e or locall law rees tgulation construction ong this work will he r complied performance of specified ora permit construction. ��`l.- Phone Number Property Owners Name Office Phone Fax.______-- Electrical Company �� __��(rpm � ( , — State Zip �a Q City -� Co.Address: State Certification/Registration# License Holder(Print): 1111014 Notarized Signature ofLieense er 10 20 JEOM fore me this day of MY llW,l rf p1 efP 1''• ? Er,,,;'�',k.,iaa; " gnattue of Notary Public s ' w , x .