1728 W PARK TER - ELECTRICAL r-\j'i
" / '`� \S CITY OF ATLANTIC BEACH
j 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-2816
Job Type: ELECTRIC ONLY
Description: ELECTRICAL - 6 OUTLETS
Estimated Value:
Issue Date: 12/7/2015
Expiration Date: 6/4/2016
PROPERTY ADDRESS:
Address: 1728 W PARK TER
RE Number: 172020-0366
PROPERTY OWNER:
Name: MITCHELL JR, FRANZ
Address: 1728 W PARK TER
GENERAL CONTRACTOR INFORMATION:
Name: CRAWFORD ELECTRIC
Address: P O BOX 51045 QA JOHN ROBERT CRAWFORD III
Phone: 904-241-5591
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: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
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ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach, FL 32233
Ph(904)247-5826 Fax(904)247-5845 1S — EL ' z cp
pp i c
JOB ADDRESS: /72 5. /, /( ,7 j'j/1 PERMIT#
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JEA INFORMATION REQUIRED ON ALL PERMITS AMPS VOLTS PHASE
VALUE OF WORK S
NEW SERVICE ❑ Overhead 1Z Underground 11 Underground up Pole
[1 Residential(Main)Service
[10-100 amps U 101-150amps ❑151-200amps amps #of Meters
DCommercial(Main)Service
D0-100 amps ❑101-150amps D 151-200amps amps 1CT Service amps
Conductor Type Size
❑Multi-Family(Main)Service
00-100 amps D 101-150amps ❑151-200amps :l amps #of Unit Meters
II Temporary Pole ❑ amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps ❑150amps 0200amps ❑ amps (1CT Service amps
ADDITIONS,REMODELS,gEPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-30amps 31-100amps 101-200amps
Appliances: 0-30amps 31-100amps 101-200amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures: 3
OTHER ELECTRICAL PROJECTS
❑Swimming Pool [1 Sign ❑Smoke Detectors Qty Transformers KVA ['Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
[1 Replace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change ❑OH 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 in,t/ct//J /2. 0. Phone Number 2W
Electrical Company riot) P 174;cZ: Office Phone 27/- SSW Fax 2y/ -?' 27
Co. Address: 230/ /91/}i 1/ •X,«)/ 1?/ City mph./€, gc,v4 StatePL Zip 3 Z24
License Holder(Print): , ov L • - ertification/Registration#42C)3c,10?6"7Q
Notarized Signature of License Holder .AY Pi'
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40,2;k,, TONIGINOLESPERGr�_,��t me this —1 day '� ., 0 r MY COMMISSION a FF I j a= EXPIRES:Octobers,2019 . `
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