582 COASTAL OAK LN NEW ELEC SERVICE CITY OF ATLANTIC BEACH
;;..., Sl 800 SEMINOLE ROAD
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Or; 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-2366
Job Type: ELECTRIC ONLY
Description: new service 200 amps
Estimated Value:
Issue Date: 10/7/2015
Expiration Date: 4/4/2016
PROPERTY ADDRESS:
Address: 582 COASTAL OAK LN
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: ERICKSON ELECTRICAL CONTRACTOR
Address: 2807 ST JOHNS QA FRANK W ERICKSON
Phone: 904-735-9271 —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: $129.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
nPh (904) 2(47--5826'Fca�x (904) 247-5845
JOB ADDRESS: `� �2_ W� ,`._ PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS 1,00 AMPS IAL VOLTS 1 PHASE
V 1 UE OF WORK$
NEW SERVICE ❑ Overhead grUnderground ❑J Underground up Pole
Residential(Main)Service ���
f 10-100 amps 101-150amps '' 15 l-200amps I 1 (1U` �) amps #of Meters
I Commercial(Main)Service
❑0-100 amps i 101-150amps 1151-200amps i amps CT Service amps
Conductor Type Size
Multi-Family(Main)Service
110-100 amps I 1 101-150amps 1 151-200amps amps #of Unit Meters
1Temporary Pole amps
SERVICE UPGRADE L 1 amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
-100 amps [ 150amps i 200amps r- amps I 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
-1 Swimming Pool Sign 1-Smoke Detectors Qty ❑Transformers KVA 1 Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
Replace Burnt/Damaged Meter Can Safety Inspection r Panel Change L 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. !'�I)'`!J1/V \ �1� I
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Property Owners Name. Phone Number
Electrical Company ' . .l/ o I. l'0 C Offi e Phon- -'0 -Fax t4 �ZLe
P Y A,{ Zip �j,G�3 Co. Address: � � YUV * - City 1. 4 ,� ". State
License Holder (Print): I \L , kl 91`k State Certification/Registration #01,000\
Notarized Signature of License Holder
Sworn and subscribed b ore me this day of 20
Signature of Notary Public