357 MAIN ST ELEC NEW SERVICE 4 4 CITY OF ATLANTIC BEACH
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SEMINOLE ROAD
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-2115
Job Type: ELECTRIC ONLY
Description: NEW SERVICE
Estimated Value:
Issue Date: 9/8/2015
Expiration Date: 3/6/2016
PROPERTY ADDRESS:
Address: 357 MAIN ST
RE Number: None
PROPERTY OWNER:
Name: Ghioto, LOFTUS, Stephen, DIANE
Address:
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
New Single Family Electrical $70.00
Trade Permit Base Fee $55.00
Total Payments: $129.00
PERJIIT IS APPROVED ONLY IN ACCORDANCE NS'ITII All. ('Iii' OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BIIILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
Ph(904)247-5826 Fax(904)247-5845
JOB ADDRESS: J6'7 �11-i N JT PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS 70® AMPS 20® VOLTS 5i,U; PHASE
200 2 'o -a / hfr5
VALUE OF WORK S I r
NEW SERVICE ❑ Overhead Underground ( i Underground up Pole
Otesidential(Main) Service
00-100 amps D 101-150amps 1-200amps amps #of Meters
OCommercial(Main)Service
00-100 amps ❑101-150amps ❑151-200amps O amps OCT Service amps
Conductor Type Size
❑Multi-Family(Main)Service
00-100 amps ❑101-150amps ❑151-200amps ❑ amps It of Unit Meters
❑Temporary Pole ❑ amps
SERVICE UPGRADE ❑ amps D CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps ❑150amps ❑200amps D amps ❑CT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-30amps 31-100amps 101-200amps
Appliances: 0-30amps 31-100amps 101-200amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
❑Swimming Pool ❑ Sign ❑Smoke Detectors_Qty ❑Transformers KVA -Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$ _
REPAIRS/MISCELLANEOUS
O Replace Burnt/Damaged Meter Can ❑Safety Inspection ❑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. 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 769�-�_10/ Phone Number 9Of/// V'iL13
Electrical Company ®C!/z/Ote Office Pho e Fax
Co.Address: 3-sIW/�IAJ.S! 9 Cit C StatefL zi1;3 33
License Holder(Print): e ertification/Registration#
Notarized Signature of License Hold , /%� � '_
Before me this 4 day of rte_.• lb/ 20 i
nJ ° Notary Public State of Ronda
G
Shirley L Graham
My Commission FF 088990 Signature of Notary P .lie WAN/
Expires 02f14f2018
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