812 Bonita Rd - Electrical - Repair J s� CITY OF ATLANTIC BEACH
s) 800 SEMINOLE ROAD
U j �" ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
, J „1 -f`
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247 -5814
JOB INFORMATION:
Job ID: 16- ELEC -8
Job Type: ELECTRIC ONLY
Description: ELECTRICAL - REPAIR
Estimated Value: $800.00
Issue Date: 1/5/2016
Expiration Date: 7/3/2016
PROPERTY ADDRESS:
Address: 812 BONITA RD
RE Number: 171101 -0000
PROPERTY OWNER:
Name: WALKER ET AL, PHILLIP B
Address: 812 BONITA RD 812 BONITA RD
GENERAL CONTRACTOR INFORMATION:
Name: QUALIFIED ELECTRICAL OF JAX LLC
Address: 849 Depaul DR
Phone: 904 - 568 -6062
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 1 5— ._ a
JOB ADDRESS: / 2— r OAI t Rd / 7 L "' zrk FL .?Z Z33 PERMIT #
JEA INFORMATION REQUIRED ON ALL PERMITS 2 00 AMPS /2.44,410 VOLTS ,s'", L PHASE
VALUE OF WORK $ 800
NEW SERVICE I 1 Overhead I 1 Underground 1 IJ Underground up Pole
❑Residential (Main) Service
00 -100 amps 111101- 150amps 0151- 200amps ❑ amps # of Meters
❑Commercial (Main) Service
II 0-100 amps ❑ 101- 150amps 0151- 200amps ❑ am s
Conductor Type Size p ❑ CT Service amps
❑Multi- Family (Main) Service
00 -100 amps ❑ 101- 150amps ❑ 151- 200amps ❑ amps # of Unit Meters
❑ Temporary Pole ❑ amps
SERVICE UPGRADE ❑ amps ❑ CT Service
amps
NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.)
❑ 100 amps ❑ 150amps 0200amps ❑ amps 0 C Service amps
tDDITIONS, REMODELS, REPAIRS, BUILD -OUTS, ACCESSORY STRUCTURES, ETC.
Outlets /Switches: rs 0- 30amps 31- 100amps 101- 200amps
Appliances: 0- 30amps 31- 100amps 101- 200amps
A/C Circuits: ,, 0- 60amps 61- 100amps
Heat Circuits: ii # circuits @ k
Number of Lighting dutlets, Including Fixtures:
)THER ELECTRICAL PROJECTS
❑ Swimming Pool ❑ Sign ❑ Smoke Detectors Qty ❑ Transformers KVA II Motors hp
IRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts /amps VALUE OF WORK $
EPAIRS/MISCELLANEOUS
❑Replace Burnt /Damaged Meter Can ❑Safety Inspection ❑Panel Change ❑ OH to UG
❑ Other:
unit 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
istruction.
)perty Owners Name (A141 kciL, Phone Number
;ctrical Company ('Q C, &/c c{ir ;c, Office Phone 764 -56 fit L .Fax
. Address: 8 tJq /)q() 1 L?r City 774-9(- State f Zip 72-Z- / 9
ense Holder (Print): I' b ' b _ o,J State Certification/Registration # ,CR J 4f20-z-
_
tarized Sign . I ' Li .+,' t I • ''�;° : M ' , I Y "--- �-
� 0 EXPIRES: October 8, 2019 1 (� _ ` /��
''.Ryf:,, ` BondedThmNotary 1 J day • i �.� 1 is ■t 1 �� _ 4 ,1 J
Sign of Notary Public Mrs �_�