146 W 14TH ST - ELECTRICAL ' r
�" , \s, CITY OF ATLANTIC BEACH
'� . .. 800 SEMINOLE ROAD
J r ATLANTIC BEACH, FL 32233
ff11 ``rr,, 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-2692
Job Type: ELECTRIC ONLY
Description: ELEC REPAIRS
Estimated Value:
Issue Date: 11/18/2015
Expiration Date: 5/16/2016
PROPERTY ADDRESS:
Address: 146 W 14TH ST
RE Number: 171064-0050
PROPERTY OWNER:
Name: BENNETT, THOMAS JR
Address: 385 5TH 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 BEACII 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 i.5 E LEE - zc,,(= .
JOB ADDRESS: ) ij 6 'LJ f ---;,-,1-- IN(,s-1' PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS 100 AMPS a1i 0 VOLTS 1 PHASE
VALUE OF WORKS 1660 00
NEW SERVICE El Overhead ❑ Underground I IJ Underground up Pole
[Residential(Main) Service
00-100 amps 0101-150amps 0 151-200amps 0 amps #of Meters
❑Commercial(Main)Service
O 0-100 amps ❑101-150amps 0151-200amps amps OCT Service amps
Conductor Type Size
❑Multi-Family(Main)Service
O 0-100 amps ❑101-150amps 0151-200amps 0 amps #of Unit Meters
[Temporary Pole ❑ amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
0100 amps ❑150amps C200amps 0 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:
OTHER ELECTRICAL PROJECTS
❑Swimming Pool C Sign 171 Smoke Detectors_Qty [Transformers KVA OMotors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK S
REPAIRS/MISCELLANEOUS Rcp1401- 1
[Replace Burnt/Damaged Meter Can [Safety Inspection [Panel Change 0OH to UG �1 r t r �jrr e d
►:Other: fa • • i _, I I a, . ••r: �iw a. I.I, s • . a
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. U114 a -7 Property Owners Name & C1Om9arl'I PS Phone Number d1OLi'(P 7 /'77 7 7
Electrical Company SSci Iiirmr Ekci-ri G ,1 �Y1G Office Phone 331'"116 0 Fax `�C((o" oil
Co.Address: ,3Co 5 U3-1i/'1.e )U City c JUL ik<01001le State 1. Zip : ;o-i
License Holder (Print): i Oh Sihijm I 1 11 State Certification/Registration# E.C. 13006791
il Notarized Signature of License Holder
'
( 4':' • HOLLY MARIE WALDEN-■ Sworn subscribed before me "'s ) 7 day of NOvexnh.t. 20 )
.. :r MY COMMISSION#EE853737 Signature of Notary Public +b_'
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uF-D15 EXPIRES November 25.2016
(401p 358-0 53 Fwnd o rySery ce.co r.