892 OCEAN BLVD - ELECTRIC CITY OF ATLANTIC BEACH
, ,,,,,,,,,,, ,
,,,,,, ,.... . , 800 SEMINOLE ROAD
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-2394
Job Type: ELECTRIC ONLY
Description: ELECTRICAL - 24 FIXTURES
Estimated Value: $500.00
Issue Date: 10/9/2015
Expiration Date: 4/6/2016
PROPERTY ADDRESS:
Address: 892 OCEAN BLVD
RE Number: 170344-0000
PROPERTY OWNER:
Name: HARRIS, ROBERT L
Address: PO BOX 40126
GENERAL CONTRACTOR INFORMATION:
Name: CORTES ELECTRIC JOSE ELECTRIC
Address: 3233 Bridgecove CIR
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: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach, FL 32233
Ph(904)247-5826 Fax Fax(904)247-5845 ` _ J--EC— Z3'Z,-.
JOB ADDRESS: ` Z e),-,J4 t\ U h V U - PERMIT#
A•t1.Ati4-1`c: &-tA : 3c,9,3
JEA INFORMATION REQUIRED ON ALL PERMITS ______AMPS ,941❑VOLTS ( PHASE
VALUE OF WORK$ „ . ��
NEW SERVICE ❑ Overhead ❑ Underground ❑J Underground up Pole
❑Residential(Main)Service
❑0-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Meters
❑Commercial(Main)Service
00-100 amps 0101-150amps ❑151-200amps ❑ amps 0 C T Service amps
Conductor Type Size
0 Multi-Family(Main)Service
00-100 amps C 101-150amps ❑151-200amps 0 amps #of Unit Meters
['Temporary Pole 0 amps
SERVICE UPGRADE 0 amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps 0150amps 0200amps 0 amps 0 C Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: ,OW 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: oi
OTHER ELECTRICAL PROJECTS
❑Swimming Pool ❑ Sign ❑Smoke Detectors_Qty ❑Transformers K V A rl Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
❑Replace Burnt/Damaged Meter Can 0 Safety Inspection ❑Panel Change OOH to UG
0 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 h el-49 1'5 Phone Number 7b'/ -_5 _,.5---- 233
Electrical Company e° - a. - --Lsre._ Office Phone Fax
4'. c
Co.Address:5 33 AN' E t� Cie. E. City_ t Staten t Zip_: t ,
License Holder(Print): &" 6S- ✓15 State Certification/Registration# -/5N337f
Notarized Signature of License Holder
Before me this day of 20
Signature of Notary Public