70 ROBERT ST ELECTRIC rtI
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: 247-5534
JOBINFORMATION:
Job ID: 15-ELEC-1310
Job Type: ELECTRIC ONLY
Description: SERVICE UPGRADE TO 200 AMPS
Estimated Value:
Issue Date: 6/4/2015
Expiration Date: 12/1/2015
PROPERTY ADDRESS:
Address: 70 ROBERT ST
RE Number: 172242-0000
PROPERTY OWNER:
Name: HEEREMA, MICHAEL
Address: 923 N 15TH AVE
GENERAL CONTRACTOR INFORMATION:
Name: RIGHTWAY ELECTRICAL CONT. INC
Address: 3551 S SANCTUARY WAY OA JACOB TODD IANNELLO
Phone: -
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Electrical Service Change $20.00
Total Payments: $79.00
PERMIT IS APPROVED ONLY W ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach, FL 32233
Ph(904)247-5826 Fax(904)247-5845
JOBADDRESS: 7o RORfn7-s sT PERMIT# 1316
JEA INFORMATION REQUIRED ON ALL PERMITS 2Q( , _AMPS 2 H G VOLTS PHASE
VALUE OF WORK$ 7 !'/00 . GG
❑ Underground ❑1 Underground up Pole
U511 wdftft*(M��
00-100amps 0101-150amps ^. t5t—;?99amps__ ❑ amps #of Meters_,
❑Commercial(Main)Service
00-100amps ❑101-150amps 0151-200amps ❑ amps OCT Service amps
Conductor Type Size
❑Multi-Family(Main)Service
00-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Unit Meters
❑Temporary Pole ❑ amps
SERVICE UPGRADE F- ?0 r, amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps ❑150amps ❑200amps ❑ amps OCT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 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:
OTHER ELECTRICAL PROJECTS
11 Swimming Pool ❑ Sign ❑Smoke Detectors_Qty ❑Transformers KVA ❑Motorshp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
❑Replace Bumt/Damaged Meter Can ❑Safety Inspection ❑Panel Change ❑OH 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.
Property Owners Name H llf E H F i•n r H R Phone Number 7 J /. - '7C/ 2
Electrical Company R I! a z Ate/ El fcrntcAc cr ti rAACTa&J OfficePhone F Cl-2 l a f Fax T TT1-2-2—ILL
Co.Address: /1203 -1 ti —09zlS /NOSfnu[ City TACK So tIvl cl k State F1Zip 72:tis
License Holder(Print): Ff 1 U State Certification/Registration# 00 H/4--
Notarized Signature or License Holder /I' �y�..��
.�axir>:awu�n efo me this�_-_day of L� 20
MEXPIRESSIONYrF 0117
E�miNE, w�24. tMignature of Notary Public
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