1195-1 MAYPORT RD SAFETYCITY OF ATLANTIC BEACH
s f 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
\�7 INSPECTION PHONE LINE 247-5814
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID:
Job Type:
Description:
Estimated Value:
Issue Date:
Expiration Date:
PROPERTY ADDRESS:
Address:
RE Number:
15-ELEC-1972
ELECTRIC ONLY
SAFETY INSPECTION
8/21/2015
2/17/2016
1195 MAYPORT RD
None
I/Rd t,,,,r
GENERAL CONTRACTOR INFORMATION:
Name: FIRST CHOICE ELECTRIC INC
Address: 716 N VALLEY FORGE RD QA LAWRENCE DAVID THOMAS
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: 1 I
PERMIT #
JEA INFORMATION REQUIRED ON ALL PERMITS _AMPS Z:46 VOLTS f PHASE
NEW SERVICE ❑ Overhead
❑Residential (Main) Service
❑0-100 amps [110 1- 15 Oamps
❑ Commercial (Main) Service
❑0-100 amps ❑ 101-150amps
Conductor Type
❑Multi -Family (Main) Service
❑0-100 amps 11101-150amps
[]Temporary Pole ❑ amps
SERVICE UPGRADE
VALUE OF WORKS 2-b6 . bd
❑ Underground ❑T Underground up Pole
❑ 151-200amps ❑ amps # of Meters
❑ 151-200amps []—amps CT Service amps
Size
❑ 151-200amps ❑ amps # of Unit Meters
[]—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: 0-3 Damps 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
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps
KVA [I Motors hp
VALUE OF WORK $
REPAIRS/MISCELLANEOUS
El Replace Burnt/Damaged Meter Can Safety Inspection El 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. 1 hereby certtty mat i nave
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
Phone Number
Electrical Company F+ lZ e +�-� Zrr-��r` ( Office Phone ZS1-133 Fax
Co. Address: —71 Ja c� t—� City tssr-0 State i=i., Zip �z?'�
License Holder (Print): r e. State Certification/Registration # P—tL Zai 1
NotarizqoifO'
ore o License Holder
Notary Public State of FloriBBef a me this ' day o 1 20—J e
Shirley L Graham
My Commission FF 08699051 tore of Notary P
Expires 02/14/2018 g