331 skate rd elec safety ' = CITY OF ATLANTIC BEACH
n 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247 -5814
JOB INFORMATION:
Job ID: 15 -ELEC -2765
Job Type: ELECTRIC ONLY
Description: SAFETY INSPECTION
Estimated Value:
Issue Date: 11/30/2015
Expiration Date: 5/28/2016
PROPERTY ADDRESS:
Address: 331 SKATE RD
RE Number: 171677 - 0000
PROPERTY OWNER:
Name: REVERSE MORTGAGE SOLUTIONS,INC
Address: 2727 SPRING CREEK DR
GENERAL CONTRACTOR INFORMATION:
Name: ELITE ELECTRICAL SERVICES LLC
Address: 11611 CAPE HORN AVE QA MICHAEL CHARLES
SCHWEITZER
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
�X-----a-71( Ph (904) 247 -5 26 Fax (904) 247 -5845
JOB ADDRESS: 33 / / PERMIT #
VALUE OF WORK $
NEW SERVICE ❑ Overhead ❑ Underground ❑J Underground up Pole
'Residential (Main) Service
00 -100 amps 101 150amps L 1 151- 200amps C amps # of Meters
11 Commercial (Main) Service
00 -100 amps - 101- 150amps 1 151- 200amps L amps -1CT Service amps
Conductor Type Size
Multi- Family (Main) Service
110 -100 amps 11 101 150amps L1151 200amps f amps # of Unit Meters
_ Temporary Pole 71 amps
SERVICE UPGRADE ❑ amps 1 CT Service amps
NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.)
❑ 100 amps ❑ 150amps 11200amps 1 amps HCT 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 Cl Smoke Detectors Qty ❑ Transformers KVA 1 Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts /amps VALUE OF WORK $
REPAIRS/MISCELLANEOUS
❑Replace Burnt/Damaged Meter Can )6afety Inspection -7 Panel Change 101-1 to UG
11 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 Compan -(( . G /C ( 7C` / ( 6 f2 Office Phone 9Ot/
Co. Address: /( / W` [ 7" e Cit ��A- State C Zip 7ZG
r
License Holder (Print): �� t A / A .C { ?/ ate e 'fication/Registration # f( 13 7 Y3
�' � i ��
Notarized Signature of License Holder i� � /
~
Before me this L ► • o A t 1 /� 20
Signature of Notary Public i • S
ill