1765 BEACH AVE - ELECTRIC e � CITY OF ATLANTIC BEACH
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1� V 800 SEMINOLE ROAD
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N, ATLANTIC BEACH, FL 32233
J INSPECTION PHONE LINE 247-5814
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ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-ELEC-1704
Job Type: ELECTRIC ONLY
Description: 15 SWITCHES
Estimated Value:
Issue Date: 7/20/2015
Expiration Date: 1/16/2016
PROPERTY ADDRESS:
Address: 1765 BEACH AVE
RE Number: 169673-0000
PROPERTY OWNER:
Name: SHAPIRO, JOEL R & SYLVIA, *
Address: 1765 BEACH
GENERAL CONTRACTOR INFORMATION:
Name: ALLSTATE ELECTRICAL CTR INC.
Address: P 0 BOX 550617 QA JAMES L. WILLIAMS
Phone: - -
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Lighting Outlets, Including Fixtures $9.00
Trade Permit Base Fee $55.00
Total Payments: $68.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITII ALL (TIN OF ATLANTIC BEACH ORDINANCES AND TIIE FLORIDA
BUILDING CODES.
4* Q10 CO
416 --8
*c% ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
Ph (904) 247-5826 Fax (904)247-5845
JOB ADDRESS: )76 l, 6 J2 PERMIT#/57407/
JEA INFORMATION REQUIRED ON ALL PERMITS VOL') AMPS alk VOLTS / PHASE
VALUE OF WORK$
NEW SERVICE ❑ Overhead n Underground 1-11 Underground up Pole
Residential(Main)Service
110-1 00 amps ❑101-150amps ❑151-200amps O amps #of Meters
L Commercial (Main)Service
0-100 amps 71101-150amps ❑151-200amps J amps OCT Service amps
Conductor Type Size
:Multi-Family(Main)Service
20-100 amps ❑101-150amps :151-200amps 1i amps #of Unit Meters
Li Temporary Pole 11 amps
SERVICE UPGRADE 0 amps O CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
:100 amps `'l50amps :200amps amps ECT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: Q 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: 6
OTHER ELECTRICAL PROJECTS
Li Swimming Pool 1 Sign Smoke Detectors_Qty _Transformers KVA _Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans 8 Fire Alarm Checklist) VALUE OF WORK$
Qty volts/amps
REPAIRS/MISCELLANEOUS :IOH to UG
LReplace Burnt/Damaged Meter Can LSafety Inspection ❑Panel Change
Li 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 SIVEP► ro Phone Number 9d /655'' SAF4
Electrical Company A//tivie. EJr*tJ 0.444. iIc Office Phone 4Z-7-7L40 Fax 1frZi1—TY7/
Co.Address: 7707 sAjiti, AZ City ajadelb..444/10_, State Zip,
License Holder(Print): C/9i9E5 L ea/401,44/s State Certification/Registration# 5-C //3
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1%., Notary PUblic�te of Florida worn and subscribed before me this / day of =�.�,ii = Commission#FF 230355
%,; - My Comm.Ex of Notary Public MAIM
N,1, eanosdO pi e r 2019 Signature o dry