2233 SEMINOLE RD # 11 - ELECTRIC (3- � `' \s, CITY OF ATLANTIC BEACH
''2 800 SEMINOLE ROAD
J ` ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
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ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-ELEC-2143
Job Type: ELECTRIC ONLY
Description: CHG OUT BREAKER FOR AC
Estimated Value:
Issue Date: 9/10/2015
Expiration Date: 3/8/2016
PROPERTY ADDRESS:
Address: 2233 SEMINOLE RD UNIT 011
RE Number: 169519-0122
PROPERTY OWNER:
Name: BERRY, MADELINE L ET AL
Address: 2233 SEMINOLE RD APT 11
GENERAL CONTRACTOR INFORMATION:
Name: PHASE ONE ELECTRIC LLC
Address: 2076 CORONA CT OLIVER VAN DE KAMP
Phone: - -
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
AC Circuits $5.00
Trade Permit Base Fee $55.00
Total Payments: $64.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach, FL 32233
Ph(904)247-5826 Fax (904) 247-5845
e,M 1
JOB ADDRESS: c)3 3 5
;no .. K 4 / I PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS LW AMPS /4)./.../i5 VOLTS / PHASE
VALUE OF WORK$ IS6
NEW SERVICE ❑ Overhead ❑ Underground ❑J Underground up Pole
❑Residential(Main)Service
00-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Meters
0Commercial(Main)Service
00-100 amps ❑101-150amps ❑151-200amps ❑ amps OCT Service amps
Conductor Type Size
0Multi-Family(Main)Service
00-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Unit Meters
UTemporary Pole ❑ amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps ❑150amps 0200amps L. amps OCT 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 lip
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$ �SG
REPAIRS/MISCELLANEOUS
❑Replace Burnt/Damaged Meter Can ❑Safety Inspection I]Panel Change ❑OH to UG
%Other: G kw.yt, 6 eia c.( Tor )Jai AA cm■4"
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 "^-4.63' 2 e-C f jJ
Phone Number
Electrical Company 1'hi St (3i €.. c-kr t Office PhonefleVCS1463? Fax
Co.Address: _.)61(,, C_-. City "SG..,. State PL Zip
License Holder(Print): Mt t.ti1G.L\ (,.n c o State Cert.' 'cation/Registration# 13665331
Notarized Signature of License Hold, /
go w,, Notary Public State of Florida <efore me this /6 d.AM,' ` l
Shirley L Graham C C 20
c < My Commission FF 086990 1►
140,01' Expires 02/14/201e ignature of Notary Pubh �� �A