4000 FLEET LANDING # 4106 - ELECTRICAL -S rL`l�.
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CITY OF ATLANTIC BEACH
r J 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-2602
Job Type: ELECTRIC ONLY
Description: ELECTRIC - 4 FIXTURES
Estimated Value:
Issue Date: 11/3/2015
Expiration Date: 5/1/2016
PROPERTY ADDRESS:
Address: 4000 FLEET LANDING BLVD
RE Number: LOC ID-0000
PROPERTY OWNER:
Name: NAVAL CONTINUING CARE
Address: 1 FLEET LANDING BLVD 1 FLEET LANDING BLVD
GENERAL CONTRACTOR INFORMATION:
Name: BARKOSKIE ELECTRICAL SERVICE,
Address: 48 S PENMAN RD QA JAMES T. HUGHES
Phone: 904-246-4731
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: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach, FL 32233 t--_ �C_z(vDz
Ph(9,041247-5"6 k,04)247-5845
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JOB ADDRESS: 4 O ..(6E1— L D f&le, 4 4104, ,PERMIT# /5-- 214-8`T
JEA INFORMATION REQUIRED ON ALL PERMITS /00 AMPS ! SVOLTS / PHASE
VALUE OF WORK$
NEW SERVICE ❑ Overhead ❑ Underground DJ Underground up Pole
Residential(Main)Service
0-100 amps ' 1 101-150amps 151-200amps amps #of Meters
a Commercial(Main)Service
0-100 amps I :101-150amps ; i151-200amps amps CT Service amps
Conductor Type Size
Multi-Family(Main)Service
0-100 amps I 1 101-150amps '151-200amps amps #of Unit Meters
Temporary Pole 1 ; amps
SERVICE UPGRADE i amps , CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
100 amps I i 150amps 200amps amps CT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: ,S 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 11 Sign I Smoke Detectors_Qty '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 OH to UG
Other: ,tf2/7Z7 / - X r /l Ober_
Permit becomes void if work does not commence within a six month period or work is suspended
read this application and know the same to be true and correct. All p visions of laws�i abandoned for six months. I hereby edrtify that!have
app pro 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 A/6 6 C j2� Phone Number 244 —g t 49,C) `-
Electrical Company 4,.., 'O .S�C. _ C /_P l':.1 4 7C Office Phone o)--16, • (-7?-?/ Fax f/C/' RA/
Co. Address: Z_cil Pr_2 7 ,Y /212 City ja, C 22A C State �L Zip 2 ._,s
License Holder(Print): J�w-4.s - State Certification/Registration# I lo 049.5V7
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�` ltadrl►P*Mc-Sim of PbrMn fore me this y of l Yl -k 20 } '-j
My Comm.��to.2017
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I ' : :r. Signature of Notary Public ( t�4
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