337 PLAZA - ELECTRICAL \S, CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
AF:' x 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-2924
Job Type: ELECTRIC ONLY
Description: ELECTRICAL - PANEL CHANGE OUT
Estimated Value: $1,150.00
Issue Date: 12/21/2015
Expiration Date: 6/18/2016
PROPERTY ADDRESS:
Address: 337 Plaza
RE Number: 170001-0000
PROPERTY OWNER:
Name: PERRITT, MALISSA
Address: 337 PLAZA
GENERAL CONTRACTOR INFORMATION:
Name: BILL THOMPSON ELECTRIC CO, INC
Address: 49 WEST 7TH ST QA WILLIAM R. THOMPSON, IV
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: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
Ph 904)247-5826 Fax (904)247-5845 Ls - _LEC-Z 9 Z...4-
JOB ADDRESS: PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS '211/17 AMPS ___'!VOLTS / PHASE
VALUE OF WORK$ //S C o Pc)
NEW SERVICE ❑ Overhead ❑ Underground ❑T Underground up Pole
❑Residential(Main) Service
00-100 amps ❑101-150amps ❑151-200amps 0 amps #of Meters
❑Commercial(Main)Service
00-100 amps ❑101-150amps 0151-200amps ❑ amps OCT Service amps
Conductor Type Size
❑Multi-Family(Main)Service
00-100 amps ❑101-150amps 151-200amps 0 amps #of Unit Meters
0 Temporary Pole ❑ amps
SERVICE UPGRADE 0 amps 0 CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps 0150amps 0 200amps 0 amps OCT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-3 Damps 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 0 Sign ❑Smoke Detectors_Qty ❑Transformers KVA ❑Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
0 Replace Burnt/Damaged Meter Can ❑Safety Inspection anel Chan ❑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. //'' ,J� �//, /�
Property Owners Name fie hr S C� 4 V`e/ .- Phone Number s( % e t,
Electrical Company BILL ?HOIKPSON ELECTRIC Office Phone Z V99--Ida/ Fax J7c2.-O.c`0
P. 0. BOX 330150
Co.Address: ATLANTIC 6 '. H, FL 51233 City State Zip
License Holder(Print): i �/ S to Certification/Registration# /300 3 /9
Notarized Si nature o • - _ ��% `_
l' A..4'64,, TONI GINDLESPERGER l
J MY COMMISSION s FF 924M,1 erne this Z' day of ai ^ _ G. 4 1
EXPIRES:October 6,2019•
�� Pubic Unde _ _ 11111■"'" ,
: •.... h,, Band-dThru btoY .Lure of Notary Public
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