800 SEMINOLE RD - ELECTRIC REPAIRS CITY OF ATLANTIC BEACH
y j 800 SEMINOLE ROAD
S 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-1420
Job Type: ELECTRIC ONLY
Description: elec repairs
Estimated Value:
Issue Date: 6/17/2015
Expiration Date: 12/14/2015
PROPERTY ADDRESS:
Address: 800 SEMINOLE RD
RE Number: 170389-0000
PROPERTY OWNER:
Name: CITY OF ATLANTIC BEACH
Address: 800 SEMINOLE RD
GENERAL CONTRACTOR INFORMATION:
Name: B & G REFRIGERATION
Address: 3230 KLINE RD THOMAS CARTER
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: $94.00
PERM1HT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
'z ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach,FL 32233
Ph(904)"247-5826 Fax(904)247-5845
JOB ADDRESS: RiA ll1 C>vU MU-)CW QA PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS _a__AMPs o2b`6 VOLTS I PHASE
VALUE OF WORK$ 00
NEWSERVICE ❑ Overhead ❑ Underground 0 Underground up Pole
❑Residential(Main)Service
❑O-100 amps D101-150amps 0151-200amps ❑ amps #of Meters
❑Commercial(Maio)Service
❑O-100 amps 11101-ISOamps 11151-200amps ❑ amps DCT Service_maps
Conductor Type Sim
❑Multi-Family(Maio)Service
00-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Unit Meters
❑Temporary Pole ❑ amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps ❑150amps ❑200amps ❑ amps ❑CT Service_amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-30amps 31-I00amps 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
1Swimming 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 Can ❑Safety Inspection ❑Panel Change DOH to UG
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Permit becemes 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 peRonnance of
construMion.
PropertyOwnersNamery� . 6- Ol l`4P— a( Phonc Numbe . a (p4
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Electrical Company Office PhoneT��l>.l�AR1 Faxes
Co.Address: Qa city ka-y. State 2L zip ut,Q
LicenseHolder(Print): ( ( S eitification/Registration# E,CfW\kU
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