1464 SEMINOLE RD - ELETRICAL '
.�� ' NS• CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
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C 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-2782
Job Type: ELECTRIC ONLY
Description: 8 FIXTURES
Estimated Value:
Issue Date: 12/1/2015
Expiration Date: 5/29/2016
PROPERTY ADDRESS:
Address: 1464 SEMINOLE RD
RE Number: 171954-0000
PROPERTY OWNER:
Name: SCHAFER JR, MAX EDWIN
Address: 1464 SEMINOLE RD
GENERAL CONTRACTOR INFORMATION:
Name: FRANKLIN ELECTRIC SERVICE
Address: 4 TALLWOOD RD QA JARRETT ADAM FRANKLIN
Phone: - -
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Lighting Outlets, Including Fixtures $4.80
Trade Permit Base Fee $55.00
Total Payments: $63.80
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH /2 /6 Lj 800 Seminole Rd, Atlantic Beach, FL 32233 /
Ph(904)247-5826 Fax (904)247-5845 --------*
JOB ADDRESS: /%(# 1 Semi at cc: goAD PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS AMPS VOLTS PHASE
VALUE OF WORKS 000 Ix)
NEW SERVICE I Overhead ❑ Underground DI Underground up Pole
0 Residential(Main)Service
0 0-100 amps 0101-150amps ❑151-200amps amps #of Meters
0 Commercial(Main)Service
0 0-1 00 amps O 101-150amps ❑151-200amps - amps OCT Service amps
Conductor Type Size
0 Multi-Family(Main)Service
00-100 amps O 101-150amps 0151-200amps ❑ amps #of Unit Meters
❑Temporary Pole ❑ amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
0100 amps 0 150amps 0200amps C] amps OCT Service amps
ADDITIONS,REMODELS REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: .. 0-30amps 31-100amps 101-200amps
Appliances: 0-30amps 31-100amps 101-200amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures: 3
OTHER ELECTRICAL PROJECTS
0 Swimming Pool ❑ Sign El Smoke Detectors_Qty ' Transformers KVA Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
❑Replace Burnt/Damaged Meter Can 0 Safety Inspection 0 Panel Change 00H 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 C Se( Phone Number
Electrical Company a-/2.4.x9 IU.I 0 Z cr/L i C 5Q-71.1)i CE Office Phone 6Z9'-'1915" Fax
Co.Address: V.o . i'Ok 5)23 7 City 3t-k ' C-14 State IL Zip 322 Lip
License Holder (Print): idg'/Zrtr 4 . f;49 ` .�
State Certification/Registration# C 1Ql3p13890
Notarized Signature of License Holdere 4 ,
Before me this d: o ObilE_ 20/
Signature of Notary Pub * ti•