30 17TH 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-1001
Job Type: ELECTRIC ONLY
Description: 2 elec fixtures
Estimated Value:
Issue Date: 4/29/2015
Expiration Date: 10/26/2015
PROPERTY ADDRESS:
Address: 30 17TH ST
RE Number: 169590-0000
PROPERTY OWNER:
Name: DOWLIN, DIANE M &WILLIAM A,
Address: 30 17TH ST
GENERAL CONTRACTOR INFORMATION: ERVICES INC.
Name: BEACHES ELECTRIC S KWOOD
Address: 214 COKESBURY CT QA TODD ASTOR LOC
Phone:
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Lighting Outlets, Including Fixtures $1.20
Trade Permit Base Fee $55.00
Total Payments: $60.20
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
Ph(904) 247-5826 Fax (904) 247-5845 77 0
JOB ADDRESS: o C's � PERMIT
JEA INFORMATION REQUIRED ON ALL PERMITS AMPS VOLTS PHASE
VALUE OF WORK S
NEWSERVICE 0 Overhead F-1 Underground Underground up Pole
[]Residential(Main) Service #of Meters
[10-100 amps El 101-1 50amps E 151-200amps E-amps
ElCommercial(Main) Service
E10-100 amps El 10 1-I 50amps El 151-200amps E-amps OCT Service amps
Conductor Type Size
E]Multi-Family(Main)Service
00-100 amps E 10 1-1 50amps El 151-200amps E_____amps of Unit Meters
0 Temporary Pole El -amps
SERVICE UPGRADE []-amps El CT Service_amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
E 100 amps E 150amps E1200amps E amps OCT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: __g_0-30amps 31-100amps -101-200amps
Appliances: 0-30amps _31-100amps -101-200amps
A/C Circuits: -0-60amps _61-100amps
Heat Circuits: # circuits @_____�kw
Number of Lighting Outlets, Including Fixtures: 2,
OTHER ELECTRICAL PROJECTS KVA E Motors hp
u Swimming Pool 0 Sign El Smoke Detectors___Qty El Transformers
FIRE ALARM SYSTEM (Requires 3 sets of plans) VALUE OF WORK$
Qty_volts/amps
REPAIRSIMISCELLANEOUS
0 Replace Bumt/Damaged Meter Can 0 Safety Inspection E]Panel Change OOH 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.
Phone Number
Property Owners Name 'L) C'J�' "-\ - gT -7
Electrical Company Bca' -e-b 5uc, ffice Phone 1 F '%Fax
Co. Address: -2-1't 00 Vt�6 QJ_ city State R Zip
rtification/Registration# !�e- \3
License Holder(Print):
Notarized Signature of License Holde
00, Notary public State of Florida efore me this d 20_/S
C)
t of
.zcr�P4 Shidey L Graham I N
My CommissW FF 086990 Signature of Notary Public
F.xpires 02/14/2018