315 11TH ST ELEC 2015 CITY OF ATLANTIC BEACH
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:
Job ID: 15-ELEC-638
Job Type: ELECTRIC ONLY
Description: 15 FIXTURES
Estimated Value:
Issue Date: 3/18/2015
Expiration Date: 9/14/2015
PROPERTY ADDRESS:
Address: 315 11TH ST
RE Number: 170099-0000
PROPERTY OWNER:
Name: BURBRIDGE, DAVID & SHANNON,
Address: 315 11TH ST
GENERAL CONTRACTOR INFORMATION:
Name: BILL THOMPSON ELECTRIC CO, INC
Address: 49 WEST 7TH ST QA WILLIAM R. THOMPSON, IV
Phone: - -
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Lighting Outlets, Including Fixtures $9.00
Trade Permit Base Fee $55.00
Total Payments: $68.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
Ph(904) 247-5826 Fax (904)247-5845
JOB ADDRESS: sjL, PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS 2-COC�7 AMPS 2�0 VOLTS PHASE
VALUE OF WORK$ 00
NEW SERVICE ❑ Overhead ❑ Underground ❑T Underground up Pole
7Residential(Main)Service
1�10-100 amps ❑101-150amps L 151-200amps _ amps #of Meters
E Commercial(Main) Service
0-100 amps E7101-150amps L 151-200amps amps :1 CT Service amps
Conductor Type Size
Multi-Family(Main)Service
❑0-100 amps L 101-150amps ❑151-200amps amps #of Unit Meters
LTemporary Pole L amps
SJERVICE UPGRADE ❑ amps _-1 CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
100 amps L 150amps is 200amps :1 amps ECT 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
D Swimming Pool L Sign E Smoke Detectors_Qty ❑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 ❑Safety Inspection Panel Change FjOH to UG
L 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 iolate the provisions of any other state or local law regulation construction or the performance of
construction.
Property Owners Name Phone Number
Electrical Company Biu Thompson E rie Co.INC Office Phone z1W-JZ01 FaxXV-eO,
P.O. a 330150
Co.Address: Atlantic Beach,Y 32233 City State Zip
License Holder(Print): hzor G State Certification/Registration#Z 5W-
Notarized Signature of License Holder
Before me this day of 20
Signature of Notary Public