707 SELVA LAKES CIR - ELECTRIC CITY OF ATLANTIC BEACH
sA 800 SEMINOLE ROAD
,j-- - r' 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-2076
Job Type: ELECTRIC ONLY
Description: ELECTRIC - REPAIR
Estimated Value: $1,000.00
Issue Date: 9/1/2015
Expiration Date: 2/28/2016
PROPERTY ADDRESS:
Address: 707 SELVA LAKES CIR
RE Number: 172027-5870
PROPERTY OWNER:
Name: LEVIN, LEON YALE
Address: 707 SELVA LAKES CIR
GENERAL CONTRACTOR INFORMATION:
Name: FRANKLIN ELECTRIC SERVICE
Address: 4 TALLWOOD RD QA JARRETT ADAM FRANKLIN
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: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH AL!. CITY OF ATLANTIC BEACH ORDINANCES AND 771E FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach,FL 32233
,t_'CC -?(j7
�- Ph(904)247-5826 Fax(904)247-5845 1 S
JOB ADDRESS: / 0 7 Ca 0 1 Ait. _S Gild F PERMIT# I C-R,AAg-//53
JEA INFORMATION REQUIRED ON ALL PERMITS AMPS VOLTS PHASE
VALUE OF WORK S
NEW SERVICE ❑ Overhead n Underground [ 1 Underground up Pole
❑Residential(Main)Service
❑0-100 amps ❑101-150amps ❑151-200amps amps #of Meters
❑Commercial(Main)Service
O 0-100 amps ❑101-150amps ❑151-200amps P amps OCT Service amps
Conductor Type Size
❑Multi-Family(Main)Service
El 0-100 amps ❑101-150amps ❑151-200amps Li amps # of Unit Meters
['Temporary Pole ❑ amps
SERVICE UPGRADE Ll amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps ❑150amps 0200amps ❑ amps ❑CT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-30amps 31-100amps 101-200amps
Appliances: 0-30amps 31-100amps 101-200amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
❑Swimming Pool ❑ Sign ❑Smoke Detectors Qty ❑Transformers KVA ['Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans) o.�
Qty volts/amps VALUE OF WORK$ 10 00.
REPAIRS/MISCELLANEOUS
L'Replace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change U OH to UG
Other: &T 1100.A F t0 PE
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 Phone Number
Electrical Company FAA 4 V.E-l.0 MC12/C j eY1.))t c:C Office Phone (P 29-149 z C Fax
Co.Address: P 0. ao,k, 5123 7 City XAk 1CH State.Fe Zip 5 2ZWO
License Holder (Print): 3tegerr /4AmYUAi State erti ication/Registration# 0YLl30/3O98
Notarized Signature of License Holder _
�) i�
•,. ; DAYNA H.WILLIAMS Before me this 151' of _. sett 20 la
.: ,!, ..; MY COMMISSION I FF 211941
' if EXPIRES.August 7,2019
�-f j4;1., Bonded PIN Notary Pu uu'w2°19vs Signature of Notary Public ..,. # a-. e,UA