319 19TH ST -ELECTRICAL ( Js, CITY OF ATLANTIC BEACH
J 800 SEMINOLE ROAD
s) ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
4Ji3
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-ELEC-2921
Job Type: ELECTRIC ONLY
Description: 8 fixtures
Estimated Value:
Issue Date: 12/18/2015
Expiration Date: 6/15/2016
PROPERTY ADDRESS:
Address: 319 19TH ST
RE Number: 172020-0920
PROPERTY OWNER:
Name: SIROIS, STEPHEN
Address: 319 19TH ST
GENERAL CONTRACTOR INFORMATION:
Name: A-ONE ELECTRICAL SERVICE INC
Address: 339 6TH AVE QA JOHN M. FLYNN, JR
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: $63.80
PE.RNIIT IS APPROVED ONLY IN ACCORDANCE 11'1'171 All. 0171' OF A'17.ANTIC BEACH ORDINANCES AND 11W FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CTTY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach,FL 32233
Ph(904)247-5826 Fax (904)247-5845
JOB ADDRESS: 31 / / �-� s(7-
PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS do 0 AMPS/o7l44Z 1/QVOLTS f PHASE
VALUE OF WORK$as'O4) 412.
NEW SERVICE n Overhead n Underground Underground up Pole
DResidential(Main)Service
00-100 amps 0101-150amps 0151-200amps ❑ amps #of Meters
❑Commercial(Main)Service
00-100 amps 0101-150amps 0151-200amps 0 amps OCT Service amps
Conductor Type Size
DMulti-Family(Main)Service
00-100 amps ❑101-150amps ❑151-200amps D amps #of Unit Meters
°Temporary Pole ❑ amps
SERVICE UPGRADE ❑ amps 0 CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
0100 amps 0150amps 0200amps ❑ amps OCT Service amps
(DDITIONS,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: y
)THER ELECTRICAL PROJECTS
❑Swimming Pool D Sign ❑Smoke Detectors_Qty OTransformers KVA []Motors hp
IRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps • VALUE OF WORK$ .
EPAIRS/MIS CELLANEOUS
°Replace Burnt/Damaged Meter Can 0 Safety Inspection ❑Panel Change OOH to UG
0Other:
rmit 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
d 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
:cified or not. The pennit does not give authority to violate the provisions of any other state or local law regulation construction or the perfonnance of
istruction.
)perty Owners Name .5 77C/P1-7,e7;%) S/A?O /S Phone Number
:ctrical Company 4- ONG Z 4e C TaP-)C.4Z -;p vice- Office Phone gU Y 6.Z1-O Fax
.Address: t 2S-1/Qvt,a(-72_3 A/6' City X State/`tee Zip 22/7
ense Holder (Print): �o/-/.•ti/ i y .✓ State Certi ation/Registration# -t!'oc.06 67s--
tarize , ure��a fs, + ifiRrWde ,. . n✓
1! b' 4 1, e0,.aM TO i 14c13,,Pubrc UndeNiii e 1 e this I `P. d. of I. ■ a� , 2• 1 6
Signature of Notary Public . a Aral re