51 Beach Ave safety elec ' "ISS1
CITY OF ATLANTIC BEACH
\
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-2311
Job Type: ELECTRIC ONLY
Description: SAFTEY INSPECTION
Estimated Value:
Issue Date: 10/1/2015
Expiration Date: 3/29/2016
PROPERTY ADDRESS:
Address: 51 BEACH AVE
RE Number: 170218-0000
PROPERTY OWNER:
Name: DECARLE TRUST, RODNEY D
Address: 58 EVANS DR
GENERAL CONTRACTOR INFORMATION:
Name: ADKINS ELECTRIC INC.
Address: 10477 NEW KINGS RD QA VIRGIL M. ATKINS
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: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
Ph(904) 247-5826 Fax(904) 247-5845
.TOB ADDRESS: 5I b c rA Guy al-1 din Ll C b-achl F1 PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITSAMPS _x.1}0 VOLTS PHASE
VALUE OF WORK$
NEW SERVICE ❑ Overhead ❑ Underground ❑1 Underground up Pole
Residential(Main) Service
r!0-100 amps ❑101-150amps ❑151-200amps LI—amps #of Meters
Commercial(Main)Service
E-10-100 amps -101-150amps 10151-200amps amps .—.CT Service amps
Conductor Type Size
Multi-Family(Main)Service
00-100 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,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 Li Transformers KVA Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans) VALUE OF WORK$
Qty volts/amps
REPAIRS/MISCELLANEOUS
Replace Burnt/Damaged Meter Can 15afety 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 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
I I i�o r 3 C YY��°S �-S f Phone Number 50 2— 470 C'
7 S - ��2
Electrical Company CA I�i n 6 Fl( cLf r 1 c 1 n(� Office Phone Fax y
Cit J rir l4s0 l m l i' State M Zip—
License
Co.Address: 10�-I"1-1 new 1��n �d y
License Holder(Print): 11,r-
I 10 S State Certification/Registration# 1;C �{[
Notarized Signature of License Holder
tdotery Public Stege of Florida
Sworn and subscribed befor a this day o 20)
Angela M wiQiams
y My Commission FF 042720 Signature of Notary Public
$o,w Expos 08127I2017