1751 ATLANTIC BEACH DR ELEC SVR �, j , CITY OF ATLANTIC BEACH
J 800 SEMINOLE ROAD
J r 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-1147
Job Type: ELECTRIC ONLY
Description: NEW SERVICE 200 AMPS
Estimated Value:
Issue Date: 5/14/2015
Expiration Date: 3/29/2016
PROPERTY ADDRESS:
Address: 1751 ATLANTIC BEACH DR
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: MCDONALD ELECTRIC
Address: 6915 WEST BEAVER ST QA LARRY BRIAN CARTER
Phone: - - —
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
New Single Family Electrical $70.00
Trade Permit Base Fee $55.00
Total Payments: $129.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach,FL 32233
Ph(904)247-5826 Fax(904)247-5845 l.7 - ,E/‘e 7/li7
JOB ADDRESS: /7 d 7 ,4Il 61717 6 09 C i PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS t u AMPS � 91)VOLTS / PHASE
VALUE OF WORK$
•
NEW SERVICE ❑ Overhead " Underground ❑J Underground up Pole
OResidential(Main)Service !
00-100 amps ❑101-150amps 151-200amps ❑ amps #of Meters
0Commercial(Main)Service
0 0-100 amps 0 101-150amps 0151-200amps 0 amps OCT Service amps
Conductor Type Size
0 Multi-Family(Main)Service
00-100 amps 0101-150amps 0 151-200amps 0 amps #of Unit Meters
['Temporary Pole 0 amps
SERVICE UPGRADE ❑ amps 0 CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
0100 amps ❑150amps 0200amps 0 amps OCT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-3 Oamps 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
O Swimming Pool 0 Sign 0 Smoke Detectors Qty 0Transformers KVA ,1 Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans) VALUE OF WORK$
Qty volts/amps
REPAIRS/MISCELLANEOUS
0 Replace Burnt/Damaged Meter Can 0 Safety Inspection ❑Panel Change 00H to UG
OOther:
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 Phone Number
Electrical Company .kit/ C / d, Office Pho e Fax
G Sr City L9 State fl Zip
Co.Address: --4e Q V� --
License Holder(Print): ___ State Certification/Registration#
Notarized Signature of License Holder
Before me this day of 20
Signature of Notary Public