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11 ROBERT ST SAFETY ELEC S, CITY OF ATLANTIC BEACH J 800 SEMINOLE ROAD T) yr ATLANTIC BEACH,FL 32233 INSPECTION PHONE LINE 247-5814 s��J319 ELECTRICAL PERMIT MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814 JOB INFORMATION: Job ID: 15-ELEC-2060 Job Type: ELECTRIC ONLY Description: safety inspection Estimated Value: Issue Date: 8/31/2015 Expiration Date: 2/27/2016 PROPERTY ADDRESS: Address: 11 ROBERT ST RE Number: None GENERAL CONTRACTOR INFORMATION: Name: CRAWFORD ELECTRIC Address: P O BOX 51045 QA JOHN ROBERT CRAWFORD III Phone: 904-241-5591 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: $94.00 PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA BUILDING CODES. ELECTRICAL PERMIT APPLICATION CITY OF ATLANTIC BEACH 800 Seminole Rd, Atlantic Beach, FL 32233 Ph(904)247-58/26 Fax (904) 247-5845 JOB ADDRESS: _ / , S�J`r_eT PERMIT# JEA INFORMATION REQUIRED ON ALL PERMITS _AMPS SLG VOLTS PHASE VALUE OF WORK$ NEW SERVICE ❑ Overhead ❑ Underground E3Underground up Pole ❑Residential(Main)Service 00-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Meters ❑Commercial(Main)Service 00-100 amps ❑101-150amps ❑151-200amps ❑ amps OCT Service amps Conductor Type Size ❑Multi-Family(Main)Service 00-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Unit Meters ❑Temporary Pole ❑ amps SERVICE UPGRADE []______amps ❑ CT Service amps NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.) ❑100 amps ❑150amps ❑200amps ❑ amps OCT 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 ❑Motors hp FIRE ALARM SYSTEM (Requires 3 sets of plans) Qty volts/amps VALUE OF WORK$ REPAIRS/MISCELLANEOUS ❑Replace Burnt/Damaged Meter Can ❑Safety Inspection []Panel Change DOH to UG ❑Other: 83, c- O.A.) 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 �-r PA A,5oPhone Number Electrical Company (..�AOy _Ur 1 ���r� ' Office Phone 76 Y zY/-fAjZ Faaxpcy x 963 Co.Address: �,R6/ i�'Inra� �'��� /` 1 City stateF-4- Zip 3� cs— License Holder(Print): R ��1v' �✓ Certification/Registration#. e Lpo may? Notarized Signature of License Holder Before me this 0 20- � — Signature of Notary Public k