523 SELVA LAKES CIR - ELECTRIC CITY OF ATLANTIC BEACH
f 800 SEMINOLE ROAD
j 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-2296
Job Type: ELECTRIC ONLY
Description: ELECTRICAL MISC REPAIR
Estimated Value: $2,500.00
Issue Date: 9/30/2015
Expiration Date: 3/28/2016
PROPERTY ADDRESS:
Address: 523 SELVA LAKES CIR
RE Number: 172027-5504
PROPERTY OWNER:
Name: LANIER, JOYCE E
Address: 523 SELVA LAKES CIR
GENERAL CONTRACTOR INFORMATION:
Name: FERRELL ELECTRIC ROLAND FERRELL
Address: 244 Sr 16 ST
Phone: 904-824-3475
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: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
C8-26-15; 14:4' :F• -'i: Tc;: E2?p'.=i-i ; 04.247E8L5 # 1/
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach,FL 32233
Ph (904) 247-5826 Fax(904)247-5845 1 .` C,l_ — G Z-c)
JOB ADDRESS: „ SSG>lLA �.A rtt 5 e,( 1k PERMIT#
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JEA INFORMATION REQUIRED ON ALL PERMITS ZOO AMPS; 2eiD VOLTS S1>vci j£, PHASE
VALUE OF WORK$
NEW SERVICE ❑ Overhead ❑ Underground 711 Underground up Pole
:Residential(Main)Service
G 0-100 amps C 101-150amps 1 151-200amps ❑ amps #of Meters
:Commercial(Main) Service
00-100 amps 0101-150amps J151-200amps C amps OCT Service amps
Conductor Type Size
3Multi-Family(Main)Service
00-100 amps J 101-150amps :151-200atnps amps #of Unit Meters
:1.Temporary Pole ::1 amps
SERVICE UPGRADE C amps ..t CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
7100 amps G i 50amps -1200amps C 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 C Sign C Smoke Detectors_Qty f1Transformers• KVA _Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of c •o
Qty volts/amps . VALUE OF WORK S -5 0 D
REPAIRS/MISCELLANEOUS
:Replace Burnt/Damaged Meter Can 2 Safety Inspection L.Panel Change DOH to UG
:Other: /Z{l S C,Wi/N.L1AO 7 frifrit ill(fA 4-g?41f 13-44 H Ito)W'(
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 doss not give authority to violate the provisions of any other state or local law regulation construction or the performance of
construction.
Property Owners Name- yC e G & Am 11.- Phone Number
Electrical Company i (, E./sc./74_1c CSC.L Office Phongey go.3pzrFax
Co.Address: Z 9 5 f�4{ I Z .4 4- l( Cite State qt.. Lip.32 Cg i4
License Holder(Print): CDUA N tg-- tI14kV-c State Certific tion/Registration#4r.—/300 6,
Notarized Signature of License fielder / :: ./ P-1---
Di'' rG,0125,41.0620-
Before me this_gat_.day of piev-nUerm 20 }3
• .f Notary Public '‹.c6. 1
� r r% Notary PubNc State of Florida
Jamie Shepherd
%coMy p Commission FF n Exres 03/24!missio2019 209493