320 PLAZA -ELECTRIC 15-ELEC-1326 -SI
`Y
CITY OF ATLANTIC BEACH
Y 800 SENHNOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOBINFORMATION:
Job ID: 15-ELEC-1326
Job Type: ELECTRIC ONLY
Description: elec for pool
Estimated Value:
Issue Date: 6/10/2015
Expiration Date: 12/7/2015
PROPERTY ADDRESS:
Address: 320 Plaza
RE Number: 169958-0000
PROPERTY OWNER:
Name: JEWELS,SAMANTHA&WILLIAMC, '
Address: 320 PLAZA
GENERAL CONTRACTOR INFORMATION:
Name: HAZOURI ELECTRIC, INC.
Address: P O BOX 56559 QA ROBERT HAZOURI
Phone: -
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Swimming Pools $40.00
Trade Permit Base Fee $55.00
Total Payments: $99.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
From:SAFE SHIP 1 904 460 0652 06/05/2015 15:25 #193 P.001/001
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach, FL 32233
Ph(904)247-5826 Fax(904)247-5845
JOB ADDRESS: CQ T PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS AMPS VOLTS _ __..PHASE
VALUE OF WORK d
NEW SERVICE ❑ Overboad ❑ Underground ❑i Underground up Pok
CResideatial(Main)Service
00.100amps 0101.150amps 0151.200amps )_amps #of Meters
❑Commorcial(Mato)Service
00-100 amps 0101-150amps 0151-200amps 0----amps CICT Service amps
Conductor Type Sim
OMulti-Famlty(Main)Scrvlce
00-100amps 0101-150elnps 13151.200amps 0�amps #of Unit Meters
OTemporary Pok 0—amps
SERVICE UPGRADE fl_amps 11 CTService—amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
0100amps 0150amps 0200amps 0_amps 11CTServioe�amps
ADDITIONS,REMODELS,REPAIRS,WVHD-OUTS,ACCESSORY STRUCTURES,ETC.
Outleta/Switches: `0-30mil `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
OSwimming POol [] Sign OSmoke Dotectors_Qty UTransforrmas KVA OMotors_hp
FIRE ALARM SYSTEM (Requires 3 sets of plana)
Qty_volts/amps VALUE OF WORKS
REPAIRS/MISCELLANEOUS
OReplace BumNllamaged Motor Can ❑Saferyinspection OPanel Change OOH to UG
OOther.
Permit bcoonees voW lfwark does not eommmee wnhm a six month
paned s work isadordiedorsswomcE fornix rkwin 1hrneyearthy that1havo
resp this 0r e0tapilooion and knew the some roou true arta correct All prov6don fango end ordinance amercing this work will bI eanpliad with wheMcr
specified or not The pcnnit don notaivc nulhodry ro violate the provision afany other wta or toed law mptlation construction or rhe perfonamea of
wnsauGbn. )) (
Property Owners Name 1 � eVU '� IJ Phone Number v�S�'tl �
Electrical Company `1 'm J ^ Office Phone L(� -3 Y &Fax
Co.Address, 0 City State_Zip
License Holder(Print): dz 0 v SW a rnttiotJR 'stration# _6 �`o v
Notarized Signature Of License Holder "� /
Before me this day of 20
Signature of Notary