378 AQUATIC DR - ELECTRIC ,j
CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
J - ATLANTIC BEACH,FL 32233
INSPECTION PHONE LINE 247-5814
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
30B INFORMATION:
Job ID: 15-ELEC-1938
Job Type: ELECTRIC ONLY
Description: ELECTRICAL - UNDERGROUND SERVICE
Estimated Value: $1.500.00
Issue Date: 8/13/2015
Expiration Date: 2/9/2016
PROPERTY ADDRESS:
Address: 378 AQUATIC DR
RE Number: 171818-5126
PROPERTY OWNER:
Name: POZIN, JESSICA
Address: 1217 N 11TH ST
GENERAL CONTRACTOR INFORMATION:
Name: CRAWFORD ELECTRIC
Address: P 0 BOX 51045 QA JOHN ROBERT CRAWFORD III
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: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach, FL 32233
Ph (904) 247-5826 Fax (904)247-5845 1 5-E L C C` 3
JOB ADDRESS: 2 7 Q iq T-,�(-/r-C , ,,�or PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS 4/62 v AMPS f%_-w VOLTS 0 PHASE
VALUE OF WORK S '511S-'0 0. °�
NEW SERVICE ❑ Overhead ❑ Underground I I Underground up Pole
17 Residential(Main)Service
0-100 amps ❑101-150amps ❑151-200amps a amps #of Meters
UCommercial(Main)Service
00-100 amps Li 101-150amps ❑151-200amps 0 amps 0 C Service amps
Conductor Type Size
❑Multi-Family(Main)Service
00-100 amps 0 101-150amps 0 151-200amps ❑ amps #of Unit Meters
❑Temporary Pole ❑ amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
0 100 amps 0 150amps L200amps ❑ amps C'CT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-30amps 31-100amps 101-200amps
Appliances: 0-30amps 31-100amps 101-200amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
❑Swimming Pool ❑ Sign ❑Smoke Detectors_Qty Transformers KVA 0 Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPA SCELLANEOUS
eplace Burnt/Damaged Meter Can 0 Safety /Ins pection ❑Panel Change ❑OH to UG
1]Other: tAdier�wP I Serua es.. /Lrn I
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. L / �/)
Property Owners Name ,,G L/h / ' << tt I Phone Number g 2— 2/J7
Electrical Company C2,,�w -0�1 0le cif. L Office PhoneloY?y/-SS7( Fax L`/t-90.
Co.Address: 2.-10i 91e X 150,4 Z.,-c/ City Nefandd. Atav4 State /,L Zip 3Z2-,(`
License Holder(Print): A / / S .to Certification/Registration#
Notarized Signature of License Holde"/ rdl _Ai ■io.
+:e orete this / 3 4ff AMIE A-- 20 1 6 _
Notary Public State of Florida ,�V
Shirley L Graham
Signature of Notary Publiic
�g� My Commission FF 086990 g y
orrJ�' Expires 02/14/2018 ■