275 Sailfish Dr 2015 Safety # 219 CITY OF ATLANTIC BEACH
r a 800 SEMINOLE ROAD
ATLANTIC BEACH,FL 32233
1 _ 'f
INSPECTION PHONE LINE 247-5814
19
f-
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION: 15-ELEC-406
Job ID:
Job Type: ELECTRIC ONLY
Description: safety inspection unit 219
Estimated Value: 2/24/2015
Issue Date:
Expiration Date: 8/23/2015
PROPERTY ADDRESS: 275 SAILFISH DR
Address:
RE Number: 170579-0000
PROPERTY OWNER:
Name: PETERSON TRUST, TERRY LEE
Address: 1500 SELVA MARINA BLVD
GENERAL CONTRACTOR INFORMATION:
Name: CRAWFORD ELECTRIC
Address: P O BOX 51045 QA JOHN ROBERT CRAWFORD III
Phone: - -
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Electrical Repairs $35.00
Trade Permit Base Fee $55.00
Total Payments: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach, FL 32233
J^ Ph(904) 247-5826 Fax (904) 247-5845
JOB ADDRESS: �5� �h /`%s� � 2-17 PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS !/ AMPS VOLTS PHASE
VALUE OF WORK$ Z,55
NEW SERVICE ❑ Overhead ❑ Underground ❑1 Underground up Pole
❑Residential(Main)Service
❑0-100 amps 1110 1-I 50amps ❑151-200amps amps #of Meters
❑Commercial(Main) Service
[10-100 amps El 101-150amps [I151-200amps ❑ amps [I CT Service amps
Conductor Type Size
❑Multi-Family(Main)Service
00-100 amps [110 1-15 Oamps El151-200amps L1amps # of Unit Meters
❑Temporary Pole ❑ amps
SERVICE UPGRADE []_____amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps ❑150amps ❑200amps ❑ amps 0 C Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-30amps 31-l 00amps 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 El Sign El Smoke Detectors_Qty [I Transformers KVA [I Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans) VALUE OF WORK$
Qty volts/amps
REPAIRS/MISCELLANEOUS
❑Replace Burnt/Damaged Meter Can Safety 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.
Property Owners Name r Phone Number
Electrical Company o r� ����d elec�f �- Office Phone �I'OY-2 y/-Si'9jFax-
Co.Address: b
�oq- City State 'e1-Zip
License Holder(Print):
at ertificatio egistration# 1--G>3OoDo 2.,(�9
Notarized Signature of License Holder '
Before me this d y of 20
Signature of Notary