275 SAILFISH DR - ELECTRIC 255 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
JOBINFORMATION:
Job ID: 15-ELEC-1403
Job Type: ELECTRIC ONLY
Description: panel change fire damage repairs
Estimated Value:
Issue Date: 6/16/2015
Expiration Date: 12/13/2015
PROPERTY ADDRESS:
Address: 275 SAILFISH DR
RE Number: 170579-0000
PROPERTY OWNER:
Name: PETERSON TRUST,TERRY LEE
Address: 1500 SELVA MARINA BLVD
GENERAL CONTRACTOR INFORMATION:
Name: BACCK ELECTRIC LLC
Address: P O BOX 6053 WILLIAM POWELL MCKINNEY
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: 275 SAH.FISH DR PERMIT# 15-RAAR-1341
JEA INFORMATION REQUIRED ON ALL PERMITS –100—AMPS _240_VOLTS 1_PHASE
VALUE OF WORK S1,800.00
NEW SERVICE ❑ Overhead ❑ Underground D Underground up Pole
❑Residential(Main)Service
E10-100amps 0101-150amps ❑151-200amps ❑ amps #of Meters
❑Commercial(Maio)Service
❑0400 amps ❑101-150amps ❑151-200amps ❑ amps :ICT Service amps
Conductor Type Size
❑Multi-Family(Main)Service
DO-100amps 101-150amps ❑151-200amps El-amps #of Unit Meters
❑Temporary Pole ❑ amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
X100amps 0150amps ❑200amps ❑ amps DCT Service amps
ADDITIONS,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 61-100amps
Heat Circuits: # circuits Qa kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
❑Swimming Pool ❑ Sign ❑Smoke Detectors_Qty ❑Transfortners KVA ❑Motom_hp
FIRE ALARM SYSTEM (Requires 3 seta of plans)
Qty_volts/amps VALUE OFWORK S
REPAMSMUSCELLANEOUS
❑Replace BumUDamaged Meter Can ❑Safety Inspection X Panel Change ❑OH to UG
❑Other._Replacing existing 100 amp Panel,Replacing wall heaters,Replacing fixtures and devices due to five.
Permit becomes void if work does trot 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 race 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 Peterson Trust Terry Lee Phone Number 904-422-7442
Electrical Company : Bacck Electric LLC Office Phone 904-781-5050_Fax904-323-4646_
Co.Address: 532 Locust ST City Jacksonville State FL_Zip 32254
S _
License Holder(Print): lt/ o s State Certification/Registration#EC 13006749_
Notarized Signature of License Hnlder. -vo
KIMBERLY OLYO Sworn and subscribed before me thi' day of 20L
^' Yr I:ONa118S10N a FFr99000 Shmattue of Notary Publi D
- EXPatE9 Fabuary 12.2019
Ipll J9aetp r4WUe •Nu.xrt