1575 MAIN ST - ELECTRICAL REPLACE DIS CONNECT j 1y'\!\f�_,
/' ', '', \ , CITY OF ATLANTIC BEACH
' " r 800 SEMINOLE ROAD
+j4_, ATLANTIC BEACH, FL 32233_11)
INSPECTION PHONE LINE 247-5814
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-ELEC-2270
Job Type: ELECTRIC ONLY
Description: ELECTRICAL - REPAIR, REPLACE DIS CONNECT
Estimated Value:
Issue Date: 9/29/2015
Expiration Date: 3/27/2016
PROPERTY ADDRESS:
Address: 1575 MAIN ST
RE Number: 172323-0000
PROPERTY OWNER:
Name: CORBIN JR ET AL, RAYMOND M
Address: 4217 COQUINA DR 4217 COQUINA DR
GENERAL CONTRACTOR INFORMATION:
Name: FIRST COAST ELECTRIC, LLC
Address: P 0 BOX 60995 QA JERRY LEE ETTINGER, JR
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: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
II
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
Ph (904) 247-5826 Fax (904) 247-5845
JOB ADDRESS:_1575 MAIN STREET PERMIT# _ ( _ Z z 7 Q
JEA INFORMATION REQUIRED ON ALL PERMITS 600 AMPS 120/240 VOLTS 3 PHASE
VALUE OF WORK$ $2,500.00
NEW SERVICE ❑ Overhead ■ Underground n1 Underground up Pole
LResidential(Main)Service
DO-100 amps l 01-150amps -200amps #of Meters
'.Commercial(Main) Service
0-100 amps 101-150amps 151-200amps 600 amps
Conductor Type Size
Multi-Family(Main) Service
0-100 amps 101-150amps 200amps #of Unit Meters
'Temporary Pole amps
SERVICE UPGRADE
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
I '
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-30amps 31-100amps 101-200amps
Appliances: 0-30amps 31-100amps 101-200amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
I? hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$ /um r 60
REPAIRS/MISCELLANEOUS
CHANGE OUT BAD 600 AMP, 3-PH, 120/240 VOLT MAIN DISCONNECT
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 / 1Y C / -✓ Phone Number
Electrical Company FIRST COAST ELECTRIC, LLC Office Phone 904-779-5491 Fax 904-777-3608_
Co.Address: 5465 VERNA BLVD City JAX State FL Zip 32205
License Holder(Print): JERRY L EFFINGER ; .tate Certification/Registration# ER13012499
Notarized Signature of License Holder /, - / ,!/j
46":':.!::4,1, THOMAS L.ANDREWS III S • i d'sus.'/e' before me 's 29TH day of Sept 2015
_�
* * MY COMMISSION t FF 106138
3 EXPIRES:July 25,2018 Signature of Notary Public
�l�TE OF ftde Bonded Thru Budget Notary Services