178 BEACH AVE ELEC CITY OF ATLANTIC BEACH
s 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-1252
Job Type: ELECTRIC ONLY
Description: TEMP LINE DROP 200AMP 240 VOLT 1 P
Estimated Value:
Issue Date: 5/28/2015
Expiration Date: 11/24/2015
PROPERTY ADDRESS:
Address: 178 BEACH AVE
RE Number: 170210-0000
PROPERTY OWNER:
Name: 178 BEACH AVE LLC
Address: 6 E BAY ST SUITE 500
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:
�&Cucr �( PERMIT#
,91,A
INFORMATION REQUIRED ON ALL PERMITS — VOLTS PHASE
VALUE OF WORKS 6;66o G�
NEW SERVICE ❑ Overhead ❑ Underground E3Underground up Pole
❑Residential (Main) Service
00-100 amps ❑101-150amps ❑151-200amps ❑ amps # of Meters
❑Commercial (Main) Service
u0 100 amps ❑101-150amps ❑151-200amps ❑ amps OCT Service amps
Conductor Type Size
❑Multi-Family (Main) Service
❑0-100 amps ❑101-150amps ❑151-200amps ❑ amps # of Unit Meters
❑Temporary Pole ❑ amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS, AC CES SORY,STRUCTURES,ETC.)
100 amps ❑150amps ❑200amps` ❑ amps O'PCT Service amps
Cl
ADDITIONS, REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES, ETC.
Outlets/Switches: 0-30amps 31-104amps 101-200amps
Appliances: 0-30amps 31-100amps 101-200amps
A/ Circuits: 0-64amps 61-100amps
Heat Circuits: # circuits @ kw
NL tuber of Lighting Ou44ets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
❑Swimming Pool ❑ Sign ❑Smoke Detectors_Qty ❑Transformers KVA ❑Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans) VALUE OF•WORIC S
tv volts/amps
ItEPA S/MISCELLANEOUS
❑keplace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change ❑OH to UG
(Jther: i/ eoR ��1L � W09
Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six trootiths. 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.
Propert Owners Name phone Number
LL l�J l�I'Ctf 'Pe Z — CI Fax
Electrical Compan -��0-
h City At� <�Cte Ft—Zip�2Z33
Co. Address:
' State Certification/Registration #_ �
License Holder (Pring : k
Notarized Signa eye of License, io �^
a Kaye Kennelly V I /1 20
( mmis DWAIe tl da
S} res 03/1 i�2
V►'ar'tir . V'w .
Signature 0 otary Public L�-