331 SKATE RD ELEC 2016 `I� CITY OF ATLANTIC BEACH
r J 800 SEMINOLE ROAD
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: 16-ELEC-225
Job Type: ELECTRIC ONLY
Description: ELECTRICAL - REPAIR RISER MAST
Estimated Value:
Issue Date: 1/28/2016
Expiration Date: 7/26/2016
PROPERTY ADDRESS:
Address: 331 SKATE RD
RE Number: 171677-0000
PROPERTY OWNER:
Name: REVERSE MORTGAGE SOLUTIONS,INC
Address: 2727 SPRING CREEK DR
GENERAL CONTRACTOR INFORMATION:
Name: ELITE ELECTRICAL SERVICES LLC
Address: 11611 CAPE HORN AVE QA MICHAEL CHARLES
SCHWEITZER
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: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233 _
Ph(904) 2a7-5826 Fax (904) 247-5845 i�{d-'EC'_
JOB ADDRESS: / ✓ �� �� PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS �1G AMPS 4AOLTS PHASE
VALUE OF WORlf$
NEW SERVICE ❑ Overhead ❑ Underground ❑7 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 El CT Service amps
Conductor Type Size
[]Multi-Family(Main)Service
❑0-100 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 El-amps ❑CT Service amps
ADDITIONS,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:
OTHER ELECTRICAL PROJECTS
❑Swimming Pool ❑ Sign ❑Smoke Detectors_Qty ❑Transformers KVA ❑Motors hp
?IRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
WPAIRS/MISCELLANEOUS
❑Replace Burnt/Damaged Meter Can ❑Safety Inspection ❑Panel Change DOH to UG
Other: &fifjll�j 9(-VP-
1Z
-n-nit 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
ad 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
ecified or not. The permit does not give authority to violate the provisions of any other state or local law regulation construction or the perfonnance of
,nstruction.
-operty Owners Name _ Phone Number
ectrical Company �t° � � Office Phone` �f3 � G Fax
�. Address: l l/ �� _1 City l State rG Zip � �V
n _ �� ff /
cense Holder (Print): < � Sta e Certificat' istration# LC
?tarized.Signature of License Holder TONI GINDLESPERGER
Before me this day of ExPI ESQ t. r ,2
Signature of Notary Public