148 W 14TH ST - ELECTRICAL t-S' te \ s f CITY OF ATLANTIC BEACH
0 ,,,,. A �� 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-2693
Job Type: ELECTRIC ONLY
Description: ELEC REPAIRS
Estimated Value:
Issue Date: 11/18/2015
Expiration Date: 5/16/2016
PROPERTY ADDRESS:
Address: 148 W 14TH ST
RE Number: None
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: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORID
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach, FL 32233
p Ph(904)247-5826 Fax (904) 247-5845
JOB ADDRESS: 1 y 0 I L)- 4 54- 1,'\ -- PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS ) 66 AMPS a qb VOLTS I PHASE
VALUE OF WORK$ 1600"60
NEW SERVICE ❑ Overhead n Underground 11 Underground up Pole
❑Residential(Main)Service
0 0-100 amps ❑101-150amps 151-200amps U amps #of Meters
❑Commercial(Main)Service
00-100 amps 0 101-150amps 0151-200amps 0 amps OCT Service amps
Conductor Type Size
❑Multi-Family(Main)Service
00-100 amps 0 101-150amps ❑151-200amps 0 amps #of Unit Meters
0 Temporary Pole ❑ amps
SERVICE UPGRADE 0 amps 0 CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
i 100 amps 0 150amps 0200amps amps CT 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:
OTHER ELECTRICAL PROJECTS
❑Swimming Pool Sign ❑Smoke Detectors Qty Transformers KVA n Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK S
REPAIRS/MISCELLANEOUS fit' price W i✓'ir�
0 Replace Burnt/Damaged Meter Can 0 Safety Inspection 0 Panel Change ❑OH to UG M41470--.6 b 9 c it•Iti1 her: :el' G2 ► . a 1 .��•. t L '-= é -P: Ye .
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 (3 W a CorrIPall.teF1 Phone Number 6),'77 77 77
Electrical Company CX�(lbfl1af akt iG/nC.. Office Phone -13-/-4-/0 V O Fax ,3j6-4/69
Co.Address: ako . n 0 -�l N� I[8 City s,�ilLJ,.f State -Zip �7
License Holder(Print):
e.k.--
�.t,,C M pov..)1 State Certification/Registration# EC*13 4,n y
Notarized Signature of License Holder V'
:**v''• HOLLY MARIE WALDEN'
Sworn bscribed before me this p day of NOucjnn 20 6
MY COMMISSION#EE853737
-.';;aa!t;' EXPIRES November 25,2016 Signature of Notary Public
(407)396-0153 FandallofarySetvice.com