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578 ROYAL PLAMS DR ELEC J� \ r s, 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 JOB INFORMATION: Job ID: 15-ELEC-1796 Job Type: ELECTRIC ONLY Description: ELECTRIC - REPAIRS Estimated Value: Issue Date: 7/27/2015 Expiration Date: 1/23/2016 PROPERTY ADDRESS: Address: 578 ROYAL PALMS DR RE Number: 171518-0000 PROPERTY OWNER: Name: WELLS FARGO BANK NA Address: P O BOX 2248 MAIL CODE Z3057-010 GENERAL CONTRACTOR INFORMATION: Name: MISTER SPARKY Address: 5570 S FLORIDA MINING BLVD 5570 FLORIDA MINING BLVD S 610 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: $94.00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. ELECTRICAL PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd, Atlantic Beach, FL 32233 q Q� Ph 904) 247-5826 Fax(904) 247-5845 84 15' EL L& 17 / .TOB ADDRESS: ��O /��'� .�fLG1/L S � � 303 3 3 PERMIT# JEA INFORMATION REQUIRED ON ALL PERMITS aelz AMPS 0 ZYD VOLTS Sf kt&C t-PHASE VAL UE OF WORK$Cl? t�I NEW SERVICE ❑ Overhead ❑ Underground ❑T Underground up Pole Residential (Main) Service -0-100 amps ❑101-150amps 151-200amps amps #of Meters Commercial(Main)Service 0-100 amps [1101-1 50amps 151-200amps amps CT Service amps Conductor Type Size Multi-Family(Main)Service --0-100 amps 101-150amps El - amps #of Unit Meters Temporary Pole - amps SERVICE UPGRADE �7 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 31-100amps 101-200amps Appliances: 0-30amps 31-100amps 101-200amps A/C Circuits: __S0-60amps 61-100amps Heat Circuits: # circuits @ kw Number of Lighting Outlets, Including Fixtures: OTHER ELECTRICAL PROJECTS Swimming Pool E, 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 Buumt/Damaged Meter Can -Safety Inspection nel Change 'i OH to UG 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 autho 'ty to violate the provisions of any other state or local law regulation construction or the performance of construction. // Property Owners Name 1!r!,�L Phone Number i�`I —'��—6 v,11 Electrical Company V S i ti:iL SQA-a2_ CS Office Phone 6/09'-90J-'CG'F-.a:x� Co. Address: ', � City JJfCX5c4t.t1iaestate f2 ZipS�aRL/ License Holder(Print): 't//�4-o ' - � R-TStat ertification/Registration#�L13�1y 1 fo Notarized Signature of License Holder •/� Sworn and subscribed before me this day of 20 Signature of Notary Public