1844 MAYPORT RD ELEC SAFETY j�9
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-1934
Job Type: ELECTRIC ONLY
Description: SAFETY INSPECTION
Estimated Value:
Issue Date: 8/13/2015
Expiration Date: 2/9/2016
PROPERTY ADDRESS:
Address: 1844 MAYPORT RD
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: SUMMIT ELECTRICAL CONTRACTORS
Address: 13790 RANCH RD QA HAROLD RICHARD HURST
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: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
Ph(904) 247-5826 Fax (904) 247-5845
JOB ADDRESS: /S PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS 0 Zbo AMPS Q( VOLTS PHASE
VALUE OF WORK$ ZJDD
NEW SERVICE ❑ Overhead ❑ Underground ❑1 Underground up Pole
--Residential(Main) Service
❑0-100 amps D 101-150amps ❑151-200amps amps #of Meters
❑Commercial(Main) Service
❑0-100 amps 1101-150amps ❑151-200amps amps ;_ CT Service amps
Conductor Type Size
Multi-Family(Main)Service
110-100 amps -101-150amps ❑151-200amps ❑ amps #of Unit Meters
,I Temporary Pole i_ amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
100 amps .1150amps ' :200amps amps ❑CT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-30amps 31-l 00amps 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
❑Swimming Pool Sign ❑Smoke Detectors Qty ❑Transformers KVA El Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
Replace Burnt/Damaged Meter Can afety Inspection ❑Panel Change ❑OH 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. nn
Property Owners Name 4 A4GL
r1 0gAf V 4 4) Phone Number �� �y7 '73N
Electrical Company (—Lk- l JU 44 L WA-,,TG4CTP 1),6ffice Phone W 7W Y6Y8Fax 701 OOC'Q
Co. Address: � 11ti�iuujj'?-AA) a/ 90+0 City CAJ I �-U. — StateFC C ZiD322J
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License Holder - % ? tate Certification/Registration# jq
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Notarized Sir#atLi Milder s
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OFF 046147 =a Sworn and subscribed before this day of � /U&OS 7' 2015
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•'64'� ;�,.• •oQ� Signature of Notary Public
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