65 19th St elec 2015 :r
CITY OF ATLANTIC BEACH
l 800 SEMINOLE ROAD
r� ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
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ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-ELEC-293
Job Type: ELECTRIC ONLY
Description: circuit for hot tub
Estimated Value:
Issue Date: 2/10/2015
Expiration Date: 8/9/2015
PROPERTY ADDRESS:
Address: 65 19TH ST
RE Number: 169723-1040
PROPERTY OWNER:
Name: SWEENEY,DAVID & PATRICIA,
Address: 65 19TH ST
GENERAL CONTRACTOR INFORMATION:
Name: AMERICAN ELECTRICAL CONTRACTOR
Address: 5065 ST AUGUSTINE RD APT 13 QA EARL W. FRICK
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: $59.60
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
_f )_
Ph(904) 247/-�58i2,6 Fax (904) 247-5845
JoB ADDRESS: �S Iq T► ; ?1(PP Ct K TTiC 1 , }'L— PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS (900 AMPS 'tD VOLTS PHASE
VALUE OF WORK$
NEW SERVICE ❑ Overhead ❑ Underground ❑T Underground up Pole
--Residential(Main) Service
❑0-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Meters
❑Commercial(Main) Service
E10-100 amps ❑101-150amps ❑151-200amps ❑ amps ❑CT Service amps
Conductor Type Size
❑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
El Swimming Pool ❑ Sign El Smoke Detectors_Qty [I 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 TT ❑Safety
Inspection (�❑P�anel`Change [I OH to UG
❑'Other: N 15`tAt l (i (0 r�I`F lai)c� b(fa V fr 4:Z> I' cc
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 Ono' �� Phone Number `7n(�(J"-F -S3S-qSD f
Electrical Company t l QW U e 1 CAI eockAt Office Phoneq { !.n-9"Y)QFax (� U-Z21099
Co.Address: - 3 tU Q tCx lSt1 J1Q �CQ C't ` i State V Zip L
License Holder (Print): W • I C=K, St to e tion/Registration#��w���/CO
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NRM
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c State of Florida
y Sworn and subscribed be f re 4tis � Oda f �(1 20
tlon EE 8507905/2017 Signature of Notary Publ c