612 STURDIVANT ELEC , 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-1294
Job Type: ELECTRIC ONLY
Description: UNIT#612, REPLACE RISER WIRE AND WEATHERHEAD.
Estimated Value:
Issue Date: 6/2/2015
Expiration Date: 11/29/2015
PROPERTY ADDRESS:
Address: 610 STURDIVANT AVE UNIT#612
RE Number: 170669-0000
PROPERTY OWNER:
Name: BYNUM ET AL, KRISTINA
Address: 81 ENGLISH LN
GENERAL CONTRACTOR INFORMATION:
Name: WATSON ELECTRIC
Address: 4456 SUNBEAM RD STE 200 RICHARD S BELLA
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: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
Ph (904) 247-5826 Fax (904) 247-5845 S` 12-1
JOB ADDRESS: &Z-, S A b/t � Air PERMIT #
JEA INFORMATION REQUIRED ON ALL PERMITS 00 AMPS c:P 0/VOLTS � PHASE
VALUE OF WORK$ 1000
NEW SERVICE ❑ Overhead ❑ Underground ❑1 Underground up Pole
Residential(Main) Service
000 amps ❑101=150amps 151 200amps ❑ amps # of Meters
Co mercial(Main) Service
..0.100 amps 1110 1 150amps ❑151 200amps amps CT Service amps
Conductor Type Size
Multi-Family(Main)Service
01 100 amps ❑101-150amps ❑151-200amps amps # of Unit Meters
Temporary Pole ❑ amps
SERVICE UPGRADE ❑ amps D CT Service amps
NEW FEE ER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
E 1 0 amps ❑150amps .200amps D] amps CT Service amps
ADDITIO1 IS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES, ETC.
Outl s/Switches: 0-30amps 31-100amps 101-200amps
Appl ances: 0-30amps 31-100amps 101-200amps
A/C ircuits: 0-60amps 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
SW mining Pool ❑ Sign []Smoke Detectors_Qty F1 Transformers KVA Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qvolts/amps VALUE OF WORK$
REPAIRS II ISCELLANEOUS
❑Re lace Burnt/Damaged Meter Can Lj ❑
Safety Inspection Panel Change OH to UG
Xot j
er: �l e I f �-tJ r
Permit becom s 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. n^-
Property O ners Name L L4Nn) Phone Number r�q-ado -39,i'
Electrical Company weft - r Office Phone -Gf,
Co. Addres : M M City A'dK State `L Zip LZ
License Holder(Print): EAAW &.419= State Certification/Registration#aVj29 3Y77
Notarized Signature of License Holder /r
DONNA D TAYLOR Sworn and subscribed �methis�—da of 20
MY COMMISSION 0 EE874S77
EXPIRES February 13,2017 Signature of Notary Pub lc
(407)398-0153 FiondeNotoyServ".tbm