871 SHERRY DR - ELECTRIC JA �
'' 1,, 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
JOB INFORMATION:
Job ID: 15-ELEC-2050
Job Type: ELECTRIC ONLY
Description: ELECTRIC -REMODEL
Estimated Value:
Issue Date: 8/28/2015
Expiration Date: 2/24/2016
PROPERTY ADDRESS:
Address: 871 SHERRY DR
RE Number: 169982-0000
PROPERTY OWNER:
Name: PALMER ET AL, CHRISTY L
Address: 871 SHERRY DR
GENERAL CONTRACTOR INFORMATION:
Name: RIVER CITY ELEC CONTRACTORS
Address: 12496 NE GATELY OAKS L QA JOHN MICHAEL SCIOLINO
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: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach, FL 32233 5-ELE —Z05C7
1 Ph(904)247-5826 Fax (904)247-5845 ! p,
JOB ADDRESS: Ej 1 ` 5 -cr— C1t PERMIT#/ b a l Sl 0-30
JEA INFORMATION REQUIRED ON ALL PERMITS AMPS VOLTS PHASE
VALUE OF WORK$
NEW SERVICE ❑ Overhead ❑ Underground I 1J Underground up Pole
0Residential(Main)Service
00-100 amps ❑101-150amps ❑151-200amps J amps #of Meters
❑Commercial(Main)Service
00-100 amps 0101-150amps 0151-200amps ❑ amps OCT Service amps
Conductor Type Size
OMulti-Family(Main)Service
00-100 amps 0101-150amps ❑151-200amps ❑ amps #of Unit Meters
❑Temporary Pole 0 amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
0100 amps ❑150amps 0200amps ❑ amps OCT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 5 0-30amps 31-100amps 101-200amps
Appliances: Z 0-30amps 31-100amps 101-200amps
A/C Circuits: 0-60amps • 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures: lv
OTHER ELECTRICAL PROJECTS
❑Swimming Pool 0 Sign 0 Smoke Detectors Qty ❑Transformers KVA OMotors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
❑Replace Bumt/Damaged Meter Can (O Safety Inspection OPanel 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
;onstruction.
?roperty Owners Name Phone Number
3lectrical Company Q 1,k_I A.Cc_‘AlriA �eJ --�^C - Office Phone S% ¶ Fax
".7:o.Address:3 3 LS ��`�-1 City . l0 • State•Zip 37-67
License Holder(Print): ����\ 2- State Certification/Registration#
Vot,r. ed Si'nature of License Holder Q
'''" 'efo this 2� day of — 20
i(*( Notary Public State of No -
• � • � Cook
di My Commgsgn EE 148683
a n Expiras0l/15/2018 signature of Notary Public ^.