4203 FLEET LANDING - ELECTRIC S LAN:ryel
M. S�, CITY OF ATLANTIC BEACH
N 2144,
800 SEMINOLE ROAD
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-2213
Job Type: ELECTRIC ONLY
Description: 2 fixtures
Estimated Value:
Issue Date: 9/18/2015
Expiration Date: 3/16/2016
PROPERTY ADDRESS:
Address: 4203 FLEET LANDING BLVD
RE Number: LOC ID-0000
PROPERTY OWNER:
Name: NAVAL CONTINUING CARE
Address: 1 FLEET LANDING BLVD 1 FLEET LANDING BLVD
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Lighting Outlets, Including Fixtures $1.20
Trade Permit Base Fee $55.00
Total Payments: $60.20
PERMIT IS APPROVED ONLY IN ACCORDANCE WFIII All CITY OF A"FLAN II(' BEACH ORDINANCES AND TIIE FLORIDA
BuILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach, FL 32233
Ph(904)247-59' 6 " i.04)247-5845 1 _ nn
E L C C ZZ13
JOB ADDRESS: 4 Z D 3 L.4w v /A/4 11L V#.Y. PERMIT#16,--"" 2 99 ,
JEA INFORMATION REQUIRED ON ALL PERMITS /OD AMPS I.2b VOLTS . 1 PHASE
VALUE OF WORK S
NEW SERVICE ❑ Overhead ❑ Underground (3 Underground up Pole
Residential(Main)Service
0-100 amps ' !10 I-150amps ,151-200amps amps #of Meters
Commercial(Main)Service
0-100 amps ' 1 101-150amps i .15 I-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 E amps CT Service^ _amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
100 amps -150amps 200amps amps CT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-30amps 31-100amps 101-200amps
Appliances: Z. 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 II Sign ; Smoke Detectors_Qty Transformers KVA Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK S
REPAIRS/MISCELLANEOUS
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 sane to be true and correct. All provisions of laws and ordinances governing this work will be complied with whether
specified or not The pemtit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of
Property Owners Name h ` 4,A D J .- Phone Number 21-4 i v Electrical Company b S C'L Q. Lo ,-. 7"7C Office Phonee /( •q?3^'/ Fax 2 CI"ei RY
Co.Address:_S-At ,/ v- L1 __. citjaxilea_afi State F Zip 32a S
License Holder(Print): . 4.w•...S state Certification/Registration# I mo o r7
•
• 'Ider 0 0
not MERRITT
if:r.., ,,, �Poeta-Stab M Rarltta : •fore me this i9 y of m G,1/4..4 ' — 20 1 J title COW Seim Feb 10.21117 ,-•
r, . ":a VeIN Signature of Notary Public c , �-
reMw Dm.Naomi . lass.