973 ATLANTIC BLVD 2015 SAFETY INSPECTION r J�,
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
J
=` 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-807
Job Type: ELECTRIC ONLY
Description: SAFETY INSPECTION
Estimated Value:
Issue Date: 4/8/2015
Expiration Date: 10/5/2015
PROPERTY ADDRESS:
Address: 973 ATLANTIC BLVD
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: VANGUARD ELEC CONTRACTORS
Address: 2375 S ST JOHNS BLUFF RD QA CHARLES B WOODWARD
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: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach, FL 32233 C
Ph (904) 247-582evj
6Fax (904) 247-5845
JOB ADDRESS: �`? PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITSAMPS VOLTS _PHASE
— _
VALUE OF WORK$
NEW SERVICE ❑ Overhead ❑ Underground ❑T Underground up Pole
❑Residential(Main) Service
00-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Meters
Ll Commercial(Main)Service
❑0-100 amps ❑101-150amps ❑151-200amps ❑ amps ❑CT 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 u amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
F1100 amps ❑150amps ❑200amps ❑ amps OCT 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
❑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 rafety 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. p p,,,� ( (; C
Property Owners Nam 0 Q- - C Q/YL fi V�, Phone Number ` 0 L'
Electrical Company v aY'NcOffice PhonO?3 a ' 1 Fax-Z-3 X-VOI0-0
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Co.Addresv'53 30 v City J 0-)4- State W. Zip 3
License Holder(Print)o In AJ C ( n V�ey_ State Certification/Registration#�=C�3c�
Notarized Signature of License Holder
p'BOB BOWERS efoemes _day of 20
:'" ': EE 098360
,�: °: Commission#
t a; Expires May 37,2013esau,9 ignature of Notary Public
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