1545 MAIN ST ELECTRIC 'r n
�o 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-1314
Job Type: ELECTRIC ONLY
Description: SAFETY INSPECTION, #7,150AMP, 120/208 3PH
Estimated Value:
Issue Date: 6/4/2015
Expiration Date: 12/1/2015
PROPERTY ADDRESS:
Address: 1545 MAIN ST
RE Number: 172325-0000
PROPERTY OWNER:
Name: PAR PRO LTD
Address: P O BOX 330177
GENERAL CONTRACTOR INFORMATION:
Name: DEPENDENT ELECTRIC INC
Address: 6360 LOUIS CLARK CT BRYAN SCOTT CAMERON
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: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach,FL 32233 -t 7
Ph(904)247-5826 Fax (904)247-58451I
JOB ADDRESS: ISaS m�. ' C�- /J4-1G } ..� n h PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS LSO AMPS 12ci-ia1C VOLTS 3 PHASE
VALUEOFWORK$ 'LSO
NEW SERVICE ❑ Overhead ❑ Underground ❑I Underground up Pole
❑Resi ential(Main)Service
00 amps ❑101-150amps ❑151-200amps ❑ amps #of Meters
//Commercial(Main)Se c
0-100 amps O1-150amps ❑151-200amps amps ❑CT Service amps
Conductor Type T'MSize 7_
❑Multi-Family(Main)Service
❑0-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Unit Meters
❑Temporary Pole ❑ amps
SERVICE UPGRADE ❑ amps ❑ CT Service mpg
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps ❑150amps 13200amps []—Mpg ❑CT 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
❑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 Canafety 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 hero fo .� Cdclf� t Phone Number 9Uk- JJBJ'Jd6
Electrical Company l'�r' I—df-L I✓I,tAt• c- Office Phone 90430110v Fax i
Co.Address: 6'� Go L— 's C t,,.1\ CT City .I�ccrm.,.. vk State 1—L- Zip 3221'L
License Holder(Print): c COM e/a^ State ertification/Registration# [R i3oi48t 4
Notarized Signature of License Holder
.Inr; i .�asir>:awwaa Before mLsfFis ` ' bay o S-�� 20
ay C(%4A RWYFFa119e0
22R'h'
ew EXPIRES:Axil alm
rIREyn Signature of Notary Public l '