169 MAGNOLIA ST - ELECTRIC f..-1' , ,° s CITY OF ATLANTIC BEACH
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r ' ? ± s 800 SEMINOLE ROAD•044 .- 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-2559
Job Type: ELECTRIC ONLY
Description: fixtures replace repair
Estimated Value:
Issue Date: 10/28/2015
Expiration Date: 4/25/2016
PROPERTY ADDRESS:
Address: 169 MAGNOLIA ST
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: BILL THOMPSON ELECTRIC CO, INC
Address: 49 WEST 7TH ST QA WILLIAM R. THOMPSON, IV
Phone: - -
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Trade Permit Base Fee $55.00
Lighting Outlets, Including Fixtures $12.00
Total Payments: $71.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach, FL 32233
Ph(904)247-5826 Fax(904)247-5845 /J----klifie g(9/
JOB ADDRESS: /67? /9 1 4. f f r ',
y / s PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS A)0 AMPS G aVOLTS 7- PHASE
VALUE OF WORK$ �O >-
NEW SERVICE ❑ Overhead ❑ Underground ❑1 Underground up Pole
Residential(Main)Service
0 0-100 amps ❑101-150amps 0 151-200amps ❑ amps #of Meters
❑Commercial(Main)Service
00-100 amps ❑101-150amps ❑151-200amps :_1 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 0 amps CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps O 150amps 0200amps 1 amps OCT Service amps
ADDITIONS,REMODELS,1PAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: ! 0-30amps 31-100amps 101-200amps
Appliances: 2 0-30amps 31-100amps 101-200amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures: 7
OTHER ELECTRICAL PROJECT
❑Swimming Pool 0 Sign Mmoke Detectors ZQty ❑Transformers KVA ❑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 ❑Panel Change 01-1 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. y� /�
Property Owners Name WA *Ilk,tit 5!'!■t Phone Number
Electrical Company .g/l7 7 4 Ply ct31/t / " -r Office Phone yt�.. 60/ Fax
/J ��//ff City Stater / zip7 )
Co. Address: /��//.i��C �3 � �'
License Holder (Print): P//1 71A 0117'001^ S ate Certification/Registration#/500 721P
Nolan ' atlidig I- . 'WM - , - / _i-- —
c oma I 0 ,��f 20 l
Shirley L Graham
►�,Fw aC:.oiia zo;a oessso Be •re me this • I da
. ' ature of Notary Pu i..'iJ . A 1.4k. ��
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