781 camelia 2015 Elec ��!r•-Lyre
IIS CITY OF ATLANTIC BEACH
s)
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:
.lob ID: 15-ELEC-376
Job Type: ELECTRIC ONLY
Description: 8 fixtures
Estimated Value:
Issue Date: 2/20/2015
Expiration Date: 8/19/2015
PROPERTY ADDRESS:
Address: 781 CAMELIA ST
RE Number: 170937-0010
PROPERTY OWNER:
Name: SCHRADER, MATTHEW H
Address: 781 CAMELIA ST
GENERAL CONTRACTOR INFORMATION:
Name: PAGEMASTERS ELECTRICAL INC
Address: 45102 MUSSLEWHITE RD TIMOTHY K PAGE
Phone• - -
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Lighting Outlets, Including Fixtures $4.80
Trade Permit Base Fee $55.00
Total Payments: $63.80
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
Ph(904) 247-5826 Fax (904)247-5845
JOB ADDRESS: ) Op/ cl? m e- 119 PERMIT #
JEA INFORMATION REQUIRED ON ALL PERMITS AMPS y U VOLTS PHASE
u
VALUE OF WORK$ 3 g
NEW SERVICE ❑ Overhead ❑ Underground ❑J Underground up Pole
[]Residential(Main)Service
❑0-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Meters
❑Commercial(Main)Service
❑0-100 amps ❑101-150amps ❑151-200amps L amps [I CT Service amps
Conductor Type Size
I]Multi-Family(Main)Service
❑0-100 amps [110 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 L amps 0C Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 3 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: _*--5
OTHER ELECTRICAL PROJECTS
[I Swimming Pool ❑ Sign El Smoke Detectors_Qty 11 Transformers KVA []Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
[I Replace Burnt/Damaged Meter Can El Safety Inspection El Panel Change OOH 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 f Phone Number
Electrical Company L119�— 1937-�S /eerx,&,wl_ Office Phone ,�13 - Fax
Co.Address: 415/D'k sS��G�- � City State f-/ Zip ,o/t
License Holder(Print): ":7i,ter o 4 7 St to Certification/Registration# e" �3a�a SSS
Notarized Signature of License Holder
Befor e this day of 20
Signature of Notary Public