1845 FORSYTH CT - ELECTRIC 1
i�` f rib
�� `:e.tip)' CITY OF ATLANTIC BEACH
r ya.� -. ,� SS1 r ) 800 SEMINOLE ROAD
j tO X 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-2145
Job Type: ELECTRIC ONLY
Description: GCIF PLUG 120 VOLT
Estimated Value:
Issue Date: 9/10/2015
Expiration Date: 3/8/2016
PROPERTY ADDRESS:
Address: 1845 FORSYTH CT
RE Number: 172097-9840
PROPERTY OWNER:
Name: METTE, CANDACE L
Address: 1845 FORSYTH CT
GENERAL CONTRACTOR INFORMATION:
Name: ELECTRIC PLUS
Address: 5358 LOSCO RD QA WILLIAM SHREWSBURY
Phone: - -
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Lighting Outlets, Including Fixtures $0.60
Trade Permit Base Fee $55.00
Total Payments: $59.60
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL (fI'Y OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
4
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach, FL 32233
Ph(904)247-5826 Fax (904)247-5845
JOB ADDRESS: 1 74:ls J Cj 1-S\. +I C-1-- s -(3-- PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS 2Q AMPS `a.L4(.3 VOLTS t PHASE
VALUE OF WORK$ -5-70
NEW SERVICE ❑ Overhead I Underground nJ Underground up Pole
❑Residential(Main)Service
00-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Meters
OCommercial(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 0151-200amps Cl amps #of Unit Meters
OTemporary Pole 0 amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps ❑150amps 0200amps ❑ amps OCT Service amps
ADDITIONS;REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-3 Damps 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 OMotors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
OReplace Burnt/Damaged Meter Can 0 Safety Inspection [Panel Change ❑OH to UG ^
❑Other: V i 1 - I D° V Q I+ GFCI plus an BQCk OPYOUSP
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. 1
Property Owners Name Can(J� C Phone Number ov(),.8'.- 75 /6
Electrical Company n e C:`r 1 C 'U S T►I\ C , Office Phone 77�--Fax
Co.Address: R t R Q LQ ice l U f i- Rd i City :3 i)( State 74, Zip 300.5-7
License Holder(Print): . l ., A ■ tnrI,:,,_, S�v �; , S .�a Certifi :tion/Registration#g 130 I aF37
Notar' • , • i •■ e d i r er %,' ... �[/��- - ✓■�
Notary Public Stata of Florida � �
°. Shirley L Graham : fore me this /� day 4i' i r 20 j
VII My Commission FF 086990 � / -
OfM1 Ezpire:02n4/2018 • gnature of Notary Publ. �I � aLl#r,, Zi ,