664 BEACH AVE - ELECTRIC r-�'`1
r1 ' `\`� 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-2707
Job Type: ELECTRIC ONLY
Description: 36 fixtures elec
Estimated Value:
Issue Date: 11/18/2015
Expiration Date: 5/16/2016
PROPERTY ADDRESS:
Address: 664 BEACH AVE
RE Number: 170128-0000
PROPERTY OWNER:
Name: MELANCON, DEJEAN JR & LAURIE, *
Address: 664 BEACH AVE
GENERAL CONTRACTOR INFORMATION:
Name: FIRST COAST ELECTRIC, LLC
Address: P 0 BOX 60995 QA JERRY LEE ETTINGER, JR
Phone: - -
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Lighting Outlets, Including Fixtures $19.20
Trade Permit Base Fee $55.00
Total Payments: $78.20
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach, FL 32233
/^ Ph(904)247-5826 Fax(904) 247-5845
11L
JOB ADDRESS: f9 �,c,L� Alt., PERMIT#
-2-c>0 240
JEA INFORMATION REQUIRED ON ALL PERMITS AMPS VOLTS PHASE
VALUE OF WORK$ I c(c>U
NEW SERVICE El Overhead ❑ Underground 1 Underground up l'ole
❑Residential(Main)Service
❑0-100 amps ❑101-150amps ❑151-200amps amps #of Meters
❑Commercial(Main)Service
00-100 amps ❑101-150amps ❑151-200amps O amps OCT Service amps
Conductor Type Size
0 Multi-Family(Main)Service
00-100 amps ❑101-150amps 0151-200amps [1 amps #of Unit Meters
Li Temporary Pole ❑ amps
SERVICE UPGRADE 0 amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps 0150amps 0200amps ❑ amps OCT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 22 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: IZ
OTHER ELECTRICAL PROJECTS
Swimming Pool ❑ Sign Cl Smoke Detectors_Qty ❑Transformers KVA []Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
OReplace Burnt/Damaged Meter Can El Safety Inspection OPanel Change DOH 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 Phone Number
Electrical Company i i ".T ('_6.,,(c_e, C (r_c,} r 1 L Office Phone 24 l-13 3 ( Fax
Co. Address: ■ 4 ( •. (2.4 1) City GP*u.,Na*, State 6L. Zip ?22
License Holder(Print): I mow re::N C.-e t 1,o ,mil cPS State Certification/Registration# EC .26 lS
Notarized Signature of License Holder`vq,..n t An I as
Before me this day of 20
Signature of Notary Public