1605 BEACH AVE - ELECTRIC S r\��l�
� ' '' �S, CITY OF ATLANTIC BEACH
r' ._ 800 SEMINOLE ROAD
j „r 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-2600
Job Type: ELECTRIC ONLY
Description: ELECTRIC - REWIRE
Estimated Value:
Issue Date: 11/3/2015
Expiration Date: 5/1/2016 _
PROPERTY ADDRESS:
Address: 1605 BEACH AVE
RE Number: 169646-0000
PROPERTY OWNER:
Name: KELLY, PATRICK
Address: P 0 BOX 55095
GENERAL CONTRACTOR INFORMATION:
Name: TRI COUNTY ELECTRICAL
Address: 11637 E COLUMBIA PRK DR QA KEVIN LEE WEIR
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: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach, FL 32233 c EL�_Z6 vv
• P
Ph(904) 247-5826 Fax (904)247-5845 J
JOB ADDRESS: He O.S 800).-4 A Ug PERMIT# 15-I2A-/}R —
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JEA INFORMATION REQUIRED ON ALL PERMITS AMPS VOLTS PHASE
VALUE OF WORK$
NEW SERVICE ❑ "Overhead ❑ Underground ❑i Underground up Pole
OResidential (Main)Service
00-100 amps 0101-150amps 0151-200amps ❑ amps #of Meters
❑Commercial(Main)Service
00-100 amps ❑101-150amps ❑151-200amps ❑ amps OCT Service amps
Conductor Type Size
0Multi-Family(Main) Service
00-100 amps ❑101-150amps 0151-200amps 0 amps #of Unit Meters
OTemporary Pole 0 amps
SERVICE UPGRADE ❑ amps 0 CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps ❑150amps 0200amps 0 amps OCT Service amps
ADDITIONS ' MODELS, PAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/ ;: .- - a 0-30amps 31-100amps 101-200amps
Appliances: a 0-3Oamps 31-100amps 101-200amps
A/C Circuits: -- 0-60amps 61-100amps
Heat Circuits: - - # circuits @ kw
Number of Lighting Outlets, Including Fixtures: /D-. (A..) R. f2 €in O .-
OTHER ELECTRICAL PROJECTS
❑Swimming Pool 0 Sign 0 Smoke Detectors Qty ❑Transformers KVA ❑Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans&Fire Alarm Checklist)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
0Replace Burnt/Damaged Meter Can 0 Safety Inspection OPanel Change OOH 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.
Property Owners Name 6 P F F C)N-f Phone Number •
Electrical Company-t CV yr l y E/e C . (drl T. /Jt/<.Office Phone y•54 boy Fax €?-4v -
Co. Address: i 1 (0 3 ? Ifs et)/,i. GL A /C City ci State (Zip ��� '
License Holder (Print): 12-2 vs r1 1^• • t"-'7 - '� S . - C- ification/Registration#/2vo/S/�11)
No r ./ `,0 -,
.o„a•Pia,, PALL
=..—A..� Notary Public-State of Florid *rorY and subscribed before m- s day of (DC-1-o b-?i� 20 1 S
•. e . •E My Comm. Expires Jul 6,2C1
V:,:-:11,1,-*// LX�-
1 % Commission # EE 202003.CC ature of Notary Public
‘��•'%°��`'s Bonded Through National Notary Assh'
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