375 Seminole Rd - Electric - 19 Fixtures SrVI�r
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`S, CITY OF ATLANTIC BEACH
l 800 SEMINOLE ROAD
it,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-2978
Job Type: ELECTRIC ONLY
Description: 19 FIXTURES
Estimated Value:
Issue Date: 12/31/2015
Expiration Date: 6/28/2016
PROPERTY ADDRESS:
Address: 375 SEMINOLE RD
RE Number: 170435-0000
PROPERTY OWNER:
Name: LOPEZ TRUST, IRIS M
Address: 5824 REBA ST
GENERAL CONTRACTOR INFORMATION:
Name: INFINITY ELECTRICAL CONTRACTNG
Address: 281 HORSETAIL AVE CURTIS D DUVALL
Phone: - -
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Lighting Outlets, Including Fixtures $11.40
Trade Permit Base Fee $55.00
Total Payments: $70.40
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd,Atlantic Beach,FL 32233
Ph(904)247-5826 Fax (904) 247-5845
JOB ADDRESS: '7-S , ,rt I NO Le '` PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS 2> AMPS 24C, VOLTS
PHASE
VALUE OF WORK$
NEW SERVICE I I Overhead ❑ Underground n1 Underground up Pole
❑Residential(Main)Service
00-100 amps 0101-150amps 0151-200amps ❑ amps #of Meters
❑Commercial(Main)Service
00-100 amps 0101-150amps 0151-200amps ❑ amps OCT Service amps
Conductor Type Size
❑Multi-Family(Main)Service
00-100 amps ❑101-150amps ❑1 S 1-200amps ❑ amps #of Unit Meters
['Temporary Pole ❑ amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps 0150amps 0200amps 0 amps OCT Service amps
iDDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-30amps 31-100amps 101-200amps
Appliances: 0-30amps I 31-100amps 101-200amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures: /g
)THER ELECTRICAL PROJECTS
❑Swimming Pool ❑ Sign ❑Smoke Detectors_Qty 0 Transformers KVA ['Motors hp
IRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps • VALUE OF WORK$ .
EPAIRS/MISCELLANEOUS
❑Replace Burnt/Damaged Meter Can 0 Safety Inspection OPanel Change ❑OH to UG
Other: -e�eX.)-E-e. Gv l e 1/,-,_ a S AAeekutb
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 permit does not give authority to violate the provisions of any other state or local law regulation construction or the performance of
tstruction.
)perry Owners Name
Phone Number
:ctrical Company .17;,F;A-i4y EZCG-Tt; ( 00,464.4111 Office Phone fi 5 3c-osc7 Fax
. Address: AoS6 A€un,e IC Ave- City 2'171 c.g.Sanuvtaz. State.FL Zip -3z 2./0
ense Holder(Print): 7' -.5, _ _ State Certification/Registration# t3ta= 5
tarized Si'nature of License Holder �—�
resa oes. Notary Public State of F br; 1 e this 2 da s . l of
`F Shirley L Graham
/ y • -3` 20 C
Void My Commisswn FF 0869 `'
V of r�o° Expires 02/14/2019 §'Ign. ' e of Notary Pub``'es 1� '