64 13th Street West ELECTRICAL �
�' - l' J CITY OF ATLANTIC BEACH
s) 800 SEMINOLE ROAD
j „N 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-2663
Job Type: ELECTRIC ONLY
Description: ELECTRICAL - 7 FIXTURES & A/C BREAKER
Estimated Value: $500.00
Issue Date: 11/12/2015
Expiration Date: 5/10/2016
PROPERTY ADDRESS:
Address: 64 W 13TH ST
RE Number: 170805-0010
PROPERTY OWNER:
Name: LANG, MARY E
Address: 64 W 13TH ST
GENERAL CONTRACTOR INFORMATION:
Name: SCHUMAN ELECTRIC INC.
Address: PO BOX 48171 QA JOHN JASPER SCHUMAN
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: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
■
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
Ph(904)247-5826 Fax (904) 247-5845 L S ~ ELEC.. - Z (o c3
il PE ADDRESS: 6i4 IN NQ3)- 13+h 5 PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS )50 AMPS 94IO VOLTS I PHASE
VALUE OF WORK$ c"7lJV• O0
NEW SERVICE ❑ Overhead 0 Underground ❑T Underground up Pole
❑Residential(Main) Service
0O-100 amps A 101-150amps ❑151-200amps r] amps # of Meters
❑Commercial(Main)Service
00-100 amps ❑101-150amps D 151-200amps I amps OCT Service amps
Conductor Type Size
❑Multi-Family(Main)Service
00-100 amps ❑101-150amps 151-200amps ❑ amps #of Unit Meters
0 Temporary Pole D amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps D 150amps 0 200amps amps OCT 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: 7
OTHER ELECTRICAL PROJECTS
El Swimming Pool Sign ❑Smoke Detectors_Qty ❑Transformers KVA El Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
❑Replace Burnt/Damaged Meter Can ❑Safety Inspectionn D Panel Change i OH to UG
)(Other: Chan, OU �4
- \ Jfe5 , 4n3 ax cl i`Q,i..
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 J V B Corn pan le 5 Phone Number -1 SS- 77 7 7
Electrical Company , Ch j rrn E 1 eC-i i c Office Phone -1M-14040 Fax 31(L-y/oLl
Co.Address: Po t)CX 4 BI 71 City JACksOnU•il le State B,Zip 3ai-i
giense Holder (Print): Jahn al)uma. D State Certification/Registration# EC I3oCC
7votarized Signature of License Holder
[0/44: HOLLY MARIE WALDEN Sworn an�' ubscribed before me this a day of NOve obP e 20 I S
i �' :'c MY COMMISSION#EE853737
-Y, ;, ,. EXPIRES November 25,2016 Signature of Notary Public
,,i071 390-0153 FiondallotarySerwce.com