1665 Selva Marina 2015 elec panel chg CITY OF ATLANTIC BEACH
J 800 SEMINOLE ROAD
s� 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-351
Job Type: ELECTRIC ONLY
Description: panel change
Estimated Value:
Issue Date: 2/17/2015
Expiration Date: 8/16/2015
PROPERTY ADDRESS:
Address: 1665 SELVA MARINA DR
RE Number: 171996-0000
PROPERTY OWNER:
Name: HEWETT, PHILLIP M
Address: 1026 N 18TH ST
GENERAL CONTRACTOR INFORMATION:
Name: UNITED ELECTRIC COMPANY OF
Address: 5716 ST AUGUSTINE RD QA JOHN E GRIFFIN JR
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: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
Ph(904) 247-5826 Fax (904) 247-5845.
JOB ADDRESS: 5 S L 1 V m a r e > r PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS Q 0 0 AMPS a q o VOLTS PHASE
•VALUE OF WORK$' 900 . 00
NEW SERVICE D Overhead Underground D Underground up Pole
❑Residential (Main) Service
00-100 amps 0101-150amps 0151-200amps ❑ amps #of Meters
❑Commercial(Main) Service
00-100 amps 0101-150amps 0151-200amps ❑ amps OCT Service amps
Conductor Type Size
❑Multi-Family(Main)Service
00-100 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 ❑150amp� 0200amps []_amps OCT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-3 Damps 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&Fire Alarm Checklist) VALUE OF WORK$
Qty volts/amps
REPAIRS/MISCELLANEOUS Xanel
❑Replace Burnt/Damaged Meter Can ❑Safety Inspection 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 n Y \ W e�f Phone Number c) �a ' 0 S
Electrical Company u n, +t 1 C �� 0-o e F J`x Office Phone 3 a 10 Fax 731 -5 3 /1
Co.Address: 5 1 j4 S} ,A`' J,S 4"i�✓e- Y- City J-C/c s0"L'' I l e- State Fl- Zip 3aa!9 7
License Holder(Print): r� '� LL-' 'j a S State Certification/Registration# e 130053(o
7911
Notarized Signature of License Holder ' '�-
Sworn and subscribed before me this 1 f day of t D r✓�✓ 20/5�
-r� —
Y AL Signature of Notary Public
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