337 PLAZA ELECTRIC CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
sy
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-965
Job Type: ELECTRIC ONLY
Description: PANEL CHANGE
Estimated Value:
Issue Date: 4/24/2015
Expiration Date: 10/21/2015
PROPERTY ADDRESS:
Address: 337 Plaza
RE Number: 170001-0000
PROPERTY OWNER:
Name: PERRITT, MALISSA
Address: 337 PLAZA
GENERAL CONTRACTOR INFORMATION:
Name: SPURGEON ELECTRIC INC
Address: 850489 US HWY QA RONALD S PEACOCK
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: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF A"rLANT1C REACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF,ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach,FL 32233
Pb (904)247-5826 Fax (904)247-5845
,SOB ADDRESS: ��� � �lqzjc� Ad PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS _2L .) AN[PS a4o VOLTS ��PRASE
VALUE OF WORK$ f3 0
NEW SERVICE 0 Overhead [] Underground []T Underground up Pole
11Residential (Main)Service
ri 0-100 amps 1..1101-150amps 0151-200a.mps (-1 amps # of Meters
13 Commercial(Main)Service
1:10-100 amps 0101-150a,mps 1*1151.-200amps 1-.1-amps :1CT Service amps
Conductor Type Size
I:...multi-Family(Main)Service
130-100 amps Ca 101-150amps x1151-200amps F Damps # of Unit Meters
0Temporary Pole 0 amps
SERVICE UPGRADE I'l amps f 1 CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
C:I 100 amps 1.::1150amps 1::...1200amps I:.::; -amps 1:.ICT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches. 0-30a.mps 31-100amps 1.01-200amps
Appliances: 0-30amps 31-100amps 1.01-200amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
1:7 Swimming Pool I Sign I ISmoke Detectors_Qty f.lTransformers KVA I IMotors hp
FIRE ALARM SYS'T'EM (Requires 3 sets of plans&Fire Alarm Checkliqt)
Qty _ volts/amps VALUE OF WORK S
REPAIRS/MTSCELLANEOUS
i 1Replacc Aurnt/T)1ama.gad Meter Can (:lSafety inspection anel Change lOH to UG
i
c
Permit becomes void itwork door not commcncc within a six month period or work is suspended or abandoned for six months. I herchy certify that I have
read this application and know the same to be trop and cortcct. All provisions of laws and ordinances governing this work will he complied with whether
specified or not. 7bc permit does not give authority to violate the provisions of any other state or local low regulation construction or the performance of
construction.
Property Owners Name 1 " u�111' { '�� 1'�'�" "1 -I Sn ga&Number
Electrical Company Office Phonek.e;S7J�Fa10
Co. L77 Z
Address: T
All
�7U .S. City U a le C. State F- Zip32mm
License Holder(Print): ._._ Oc"1��� �` State Certification/Registration
Notarized Signature of License Holder ._.. Of- cae:�t
aimate" VICKTE BiELLING Sworn and subscribed before me this day of 1 20L,
MV COMMis910N N EM9479 1
EXPIRES!sePa,,bw26,2016 Signature of Notary Public
CITY OF ATLANTIC BEACH
{ 800 SEMINOLE RD
ATLANTIC BEAC,FL 32233
04/241015 13;03;42
CREDIT CARD
CITY OF ATLANTIC BEACH VISA SALE
800 SEMIllOLE ROAD CARD tt XXXXXXXXXXXX6594
ATLANTIC BEACH, FL 32233
l PHONE (904 347-5855 INVOICE 0002
Cashier id: aspcust\atlbbja
SEQ#: 0002
Receipt Date: 4/2412015 Batch#; 000017
Receipt Number: OS-66596 Approval Code; 024095
Jot, ID: 15Manual
-ELEC-965 - PANEL CHANGE EDBPR - Entry Method:
State Elec DBPR Surcharge $2.00 Mode: Online
Job ID: 15-ELEC-965 - PANEL CHANGE EDCA TaKAmount; $0.00
State Elec DCA Surcharge $2.00 Card Code, M
Job ID: 15-ELEC-965 - PANEL CHANGE ELIC - SALE AMOUNT
f Electrical Repairs $35.00
Job ID: 15-ELEC-965 - PANEL CHANGE TP - 1r
ade Permit Base Fee $55.00
CUSTOMER COPY
Amount Due: $94.00
Tender information: Cash $94.00
Tender Type: CC
Tender Amount: $94.00
4
Change Due: $0.00
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