1665 SELVA MARINA DR 15-ELEC-1503 r\,\J\
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' ' '�S CITY OF ATLANTIC BEACH
t ''`° ..f 800 SEMINOLE ROAD
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ATLANTIC BEACH, FL 32233
>N INSPECTION PHONE LINE 247-5814
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID:
15-ELEC-1503
Job Type: ELECTRIC ONLY
Description: ELEC FOR AC
Estimated Value:
Issue Date: 6/24/2015
Expiration Date: 12/21/2015
PROPERTY ADDRESS:
Address: 1665 SELVA MARINA DR
RE Number: 171996-0000
PROPERTY OWNER:
Name: HEWETT, PHILLIP M
Address: 1026 N 18TH ST
GENERAL CONTRACTOR INFORMATION:
Name: ADVANCED ELECTRICAL CONTRACTOR
Address: 11110 BUD RD QA BENJAMIN C. DEMBY, JR
Phone: - - _
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
AC Circuits $5.00
Trade Permit Base Fee $55.00
Total Payments: $64 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: \ `J� 1\) G— l-v� )W\ Or(\i — PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS 7.i t9° AMPS (2-)A 0 VOLTS I PHASE
VALUE OF WORK S
NEW SERVICE ❑ Overhead ❑ Underground I _1J Underground up Pole
Residential (Main)Service
0-100 amps . 101-150amps 151-200amps amps # of Meters
Commercial(Main)Service
0-100 amps 101-150amps 151-200amps amps CT Service amps
Conductor Type Size
Multi-Family(Main)Service
0-100 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 1200amps amps 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: '.. p0 0-60amps 61-I00amps
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) /J
Qty volts/amps VALUE OF WORK S L-- •
REPAIRS/MISCELLANEOUS
Replace Burnt/Damaged Meter Can ` Safety Inspection :Panel Change SOH 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. 4I1 C/f
Property Owners Name V" " p ) A \ Phone Number Di\
Electrical Company Aci 1' e.&rte L Office`Phone 361K-�lLl`�,(? Fax77iV 1221
Co. Address: (b061 PW\'QS \,..,\...).." City J State -Zip -5 22.07
License Holder(Print): ( eate.IL. a-t it,..`, State Certification/Registration# CG/3VO 5 o-3
N( arsv, tgnature q 'Qicc a Ho er
��• ;�,S•. Notary Pt:: State o1 Florida orn and subscribed before me this 9,/4441 day of �I,ft 20 17
I %. Ii :4 My Coma: E4,res Mar 2.2016`
�•.,, � Commiss or 0 FF 097714 „nature of Notary Public 7I�tkkO lc �✓