50 FORRESTAL CIR ELECTRICAL 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-861
Job Type: ELECTRIC ONLY
Description: 56 CIRCUITS-SWITCHES
Estimated Value:
Issue Date: 4/16/2015
Expiration Date: 10/13/2015
PROPERTY ADDRESS:
Address: 50 FORRESTAL CIR
RE Number: 171758-0000
PROPERTY OWNER:
Name: PARKS ET AL, LARRY W,
Address: 5348 TIMUQUANA RD 5348 TIMUQUANA RD
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Lighting Outlets, Including Fixtures $33.60
Trade Permit Base Fee $55.00
Total Payments: $92.60
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 73
800 Seminole Rd,Atlantic Beach, FL 32233
r`) f�n d�r Ph(904)247-5826 Fax(900+4)247-5845
)'(
JOB ADDRESS: �`'' g/ FAL 6,1 eczf- Sot:,-T-#f PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS _qeAMPS y VOLTS �rG ,4 PHASE
VALUE OF WORK S 151 q
NEW S RVICE erhead ❑ Underground D Undelgrouod up Pole
sidend (Main)Service
00-100 amps 0101-ISOamps Al--200amps amps #of Meters
❑Commercial(Main)Service
00-100 amps ❑IO1-150smps 1:1151-200amps - amps CT Service amps
Conductor Type Size
OMulti-Family(Main)Service
00-100 amps _'101-150amps 1:1151-200amps = amps #of Unit Meters
❑Temporary Pole �' amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
[1100amps 1,1I50amps I200amps ❑ amps ❑CT Service amps
ADDTTIONS,REMODELS,REPAIRS,BUH-D-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-30amps 31-100amps 101-200amps
Appliances: 0-30amps 31-100amps 101-200amps
A/C Circuits: 0-60amps 1-I00amps
Heat Circuits: 1 # circuits @�kw (,(t
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
❑Swimming Pool ❑ Sign ❑Smoke Detectors_Qty IlTmnsfortum KVA []Motors_hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK S
REPAIRS/MISCELLANEOUS
❑Replace Bunt/Damaged Meter Can ❑Safety Inspection f I Panel Change ❑OH to UG
OOther:
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 smte or local law regulation construction or the performance of
construction.
Property Owners Namely S It Phone Number r71
Electrical Compan mil (_!-_t.�j _ Office Phon( -7-"Fax
Co. Address: Ci T WAr t o Stale Zi
License Rader(Print /Lta/O2 State Certification/Registration#Ee 131)0416
Notarized Signature of License Holder 1
foafwtr. HaanPaai smmarona. ora an scribed fore a 's I da -.L 2C ,
Shirley[ sonam
Mr cemm�s rr oeeaso S true of Notary Pu
Mr.� 6pues 02/tC2o10