800 Sherry Dr elec undergrd to overhead 2015 \J1j
CITY OF ATLANTIC BEACH
S 800 SEMINOLE ROAD
- 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-736
Job Type: ELECTRIC ONLY
Description: REWIRE OVERHEAD TO UNDERGROUND 200 AMPS 240 V
Estimated Value:
Issue Date: 3/30/2015
Expiration Date: 9/26/2015
PROPERTY ADDRESS:
Address: 800 SHERRY DR
RE Number: 170393-0000
PROPERTY OWNER:
Name: EGGERS, WALTER E
Address: 800 SHERRY DR
GENERAL CONTRACTOR INFORMATION:
Name: IMPULSE ELECTRIC
Address: 4271 YVONNE TER QA RUSS TYLER BROKA
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: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
Ph (904) 247-5826 Fax (904) 247-5845
.TOB ADDRESS: <9-"G`�d2L PERMIT# - -(T
JEA INFORMATION REQUIRED ON ALL PERMITS C) AMPS �VOLTS PHASE
VALUE OF WORK$
NEW SERVICE ❑ Overhead Underground QT Underground up Pole
❑Residential(Main) Service
110-100 amps ❑101-150amps ❑151-200amps L amps # of Meters
L1 Commercial(Main)Service
110-100 amps ❑101-150amps ❑151-200amps ❑ amps OCT Service amps
Conductor Type Size
❑Multi-Family(Main)Service
❑0-100 amps Cl 101-150amps ❑151-200amps LI-amps #of Unit Meters
[]Temporary Pole ❑ amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
Cl 100 amps 11150amps 11200amps ❑ amps OCT 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 ❑ Sign ❑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 F1 Safety Inspection _ Panel Change El OH to UG
Other: l� ,
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 Phone Number /'
Electrical Company �P'1 E'(�'t_c, 6t-��T�i L- Office Phone q0+7 �-t ax
Co.Address: 4Z1 l 0QAW,.::, City State= Zip 7J�
License Holder(Print): S IT-3Q, State Certification/Registration# ES.l_2jb i 2qC
Notarized Signature of License Holler
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