1760 SELVA MARINA DR ELEC CITY OF ATLANTIC BEACH
j 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-1216
Job Type: ELECTRIC ONLY
Description: BREAKER CHANGE
Estimated Value:
Issue Date: 5/21/2015
Expiration Date• 11/17/2015
PROPERTY ADDRESS:
Address: 1760 SELVA MARINA DR
RE Number: 172009-0000
PROPERTY OWNER:
Name: HESSION, FRANK W
Address: 1760 SELVA MARINA DR
GENERAL CONTRACTOR INFORMATION:
Name: ADVANCED WIRING SERVICES INC.
Address: 3061 PHILLIPS HIGHWAY ST QA WALTER WILLIAM
GILLIAM
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: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
Ph(904)247-5826 Fax(904) 247-5845
JOB ADDRESS: G� 6(1J,IC� /– n'�C�. � PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS I.CO AMPS VOLTS PHASE
VALUE OF WORK$ t 0 C3 ' (9 C)
NEW SERVICE ❑ Overhead ❑ Underground ❑1 Underground up Pole
❑Residential(Main)Service
❑0-100 amps ❑101-150amps ❑151-200amps El—amps #of Meters
❑Commercial(Main)Service
00-100 amps 11101-1 50amps ❑151-200amps ❑ amps OCT Service amps
Conductor Type Size
❑Multi-Family(Main)Service
00-100 amps ❑101-150amps ❑151-200amps El—amps #of Unit Meters
❑Temporary Pole ❑ amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps ❑150amps 11200amps ❑ amps 0 C Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-3 Damps 31-l 00amps 101-200amps
Appliances: 0-30am s 31-100amps 101-200amps
PP P
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 ❑Safety Inspection ❑Panel Change 0 O to UG
HOther:/ `CSC.� BSC A : r Cc,NAzKo-`SL-
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. a U
Property Owners Name I_ t,%X(-CK �It,:5s� r,V\ Phone Number
Electrical Company _ter &&C,ol�t���. �-�-� Office Phone 4t'l'4ty-t 6 Fax 21-12?4
Co.Address: I1!t k^v 7�"' `D` City ��1�-State � VZip' -
License Holder(Print): I tw (,-) State Certification/Registration# CC ( 3066803
No
0 • •RITTANIE GILD20
20 /�
Notary Public•sateore me this�0 ` day of �J
.., ° My Comm.Expires M
"'•'fa��d;p'� Commission 0 FFnature of Notary Public