1021 ATLANTIC BLVD # 1011 r
t
`s, CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
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-2835
Job Type: ELECTRIC ONLY
Description: ELEC SAFETY UNIT 1011
Estimated Value:
Issue Date: 12/8/2015
Expiration Date: 6/5/2016
PROPERTY ADDRESS:
Address: 1021 ATLANTIC BLVD
RE Number: 177602-0040
PROPERTY OWNER:
Name: EQUITY ONE ATLANTIC VILLAGE,
Address: 16 NE MIAMI GARDENS DR ATTN: TREASURY DEPT
GENERAL CONTRACTOR INFORMATION:
Name: ALLBRIGHT MANAGEMENT PROFESSIONALS INC
Address: 7818 Professional PL
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: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLAi TIC BEACH
800 Seminole Rd, Atlantic Beach, FL 3223
Ph (904) 247-5826 Fax (904) 247-58
JOB ADDRESS: .0 tv,I ERMIT#
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JEA INFORMATION REQUIRED ON ALL PERMITS 2 0 n AMPS VOLTS PHASE
/y) eYe k :� 9 g 0 q 0 VALUE OF WORK$ 7_q0-P-9-
NEW
0 0NEW SERVICE ❑ Overhead ❑ Underground ❑J Underg:ound up Pole
Residential(Main) Service
0-100 amps 101-150amps 151-200amps amps #of Meters
Commercial(Main) Service
0-100 amps 101-150amps 151-200amps arnps CT Service amps
Conductor Type Size
Multi-Family(Main) Service
0-100 amps 101-150amps 15 l-200amps amps #of Unit Meters
Temporary Pole amps
SERVICE UPGRADE amps CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
100 amps 150amps 200amps 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 Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
Replace Burnt/Damaged Meter Can /afety Inspection Panel Change OH to UG
Other:
Pen-nit 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 A, & 44e- Phone Number 10 q a 9,9 -2 2 22
Electrical Company T j4 M 4NAiretWZOffice Phone 9a QAB. 0-FOeFax �/�'a,0.3o7/
Co. Address: 7919 7'he`t eS�110 JV r4 0"j City 2491
>�09 State F Zip ,
License Holder (Print): Ekic Mcre_eo State Certification/Registration#
Notarized Signature o f License Holder
f
Sworn and subscribed before me this _?V day of ./U& �l°E�ID(�� 20�
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tate of Fiorlday agooA�Signature of Notar Publicn FF 2133592019