157 BELVEDERE ST - ELECTRIC J - ''
. S f CITY OF ATLANTIC BEACH
A s) 800 SEMINOLE ROAD
j=y: ATLANTIC BEACH, FL 32233
..) INSPECTION PHONE LINE 247-5814
.k4r 1119'
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-ELEC-2144
Job Type: ELECTRIC ONLY
Description: ELECTRIC - 12 OUTLETS AND SWITCHES
Estimated Value: $1,500.00
Issue Date: 9/10/2015
Expiration Date: 3/8/2016
PROPERTY ADDRESS:
Address: 157 BELVEDERE ST
RE Number: 170584-0000
PROPERTY OWNER:
Name: BURCH, ROBERT & LESLEE ANN, *
Address: 157 BELVEDERE ST
GENERAL CONTRACTOR INFORMATION:
Name: FIRST CHOICE ELECTRIC INC
Address: 716 N VALLEY FORGE RD QA LAWRENCE DAVID THOMAS
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: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITII ALL CITY OF ATLANTIC 13F:AC11 ORDINANCES AND "HIE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
Ph (904) 247-5826 Fax (904) 247-5845 (5-CLEC -Z 14 Q'
JOB ADDRESS: PERMIT# 1 - 19 8 3
JEA INFORMATION REQUIRED ON ALL PERMITS i S\ AMPS 2..(4.6 VOLTS PHASE
VALUE OF WORK$ l�n
NEW SERVICE ❑ Overhead I >e Underground nl Underground up Pole
Residential (Main) Service
0-100 amps 101-150amps 151-200amps amps #of Meters
Commercial(Main) Service
0-100 amps 101-150amps 151-200amps amps CT Service amps
Conductor Type Size
Multi-Family(Main)Service
0-100 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 CT Service amps
ADDITIONS,REMO6ELS REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES, ETC.
Outlets/Switches: / Z, 600amps 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 OH to UG
Other: /4 e `,-,,� or
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 � L'S ��
L4 >'r^. , Phone Number
Electrical Company V/ t2.e-( C mac, ;'i-e,-f - -, Office Phone Zy 1 -/ 331 Fax
Co. Address: `71 co ✓�, I r o.r rk-, ca.cf City -c P 6 c 1- State FL Zip -20-2-1441/
License Holder (Print): Lc, vac tJ e l lam,,�,, t State Certification/Registration# C=G
Notarized Signature of Lice , older
4000, Notary Public State of Florida Sworn and subscribed before e this / G da , � 201.5-
�; Shirley L Graham086990
My Commis`-i°^FF Signature of Notary Publi _ r
eir Expires 0211412018