258 Pine St - Electrical Outlet 250 Volt Spa ��" ;, S\ CITY OF ATLANTIC BEACH
ti j 800 SEMINOLE ROAD
Vj 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-2968
Job Type: ELECTRIC ONLY
Description: Electrical outlet 250 volt spa
Estimated Value: $900.00
Issue Date: 12/30/2015
Expiration Date: 6/27/2016
PROPERTY ADDRESS:
Address: 258 PINE ST
RE Number: 170553-0000
PROPERTY OWNER:
Name: DEL GALLOWAY, CHARLES
Address: 912 NW F ST APT 700
GENERAL CONTRACTOR INFORMATION:
Name: ELECTRIC PLUS
Address: 5358 LOSCO RD QA WILLIAM SHREWSBURY
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: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH " C - a�
800 Seminole Rd, Atlantic Beach,FL 32233
Ph(904) 247-5826 Fax (904)247-5845
JOB ADDRESS: PI (\ C Si PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS Od AMPS -(3.41❑VOLTS I PHASE
VALUE OF WORK$ l '
NEW SERVICE ❑ Overhead I I Underground nT Underground up Pole
OResidential(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
0Multi-Family(Main)Service
00-100 amps D 101-150amps C 1151-200amps 0 amps #of Unit Meters
❑Temporary Pole ❑ amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
0100 amps 0150amps D200amps 0 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:
)THER ELECTRICAL PROJECTS
0 Swimming Pool 0 Sign ❑Smoke Detectors Qty ❑Transformers KVA ❑Motors hp
IRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps • VALUE OF WORK$ .
EPAIRS/MISCELLANEOUS
OReplace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change OOH to UG
❑Other: LA c ) 1 - L0 v d 1.7 1 SO Amp 3 pa c 1 f GU S )-
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 performance of
Istruction.
)perty Owners Name C°1 Ga 1 l O W q Phone Number (9.6" ----360 -0
:ctrical Company �1 e L'k'-('� C. ��C.)5� ��9
o t; . Office Phone Tr3— 7 ax
.Address: i t I c( Loy,k e Rio-P-P RC\, City Q X State 1 Zip S
ense Holder(Print : , __ -_-_. Nfi, h re - aae G"ertific a ion/Registration# ER130 / 3
tarized S' h
""'" 70NI GIN[KE ERGER WI 1411.-L, t,\ EXPIRES:October 6,2019 �ij,
e
dr
a+ded tmu Notary Pu' •ty --I e this 3 0 day of ! ) _ A 20 (�
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Signature of Notary Public ft /E