65 19th St - Remodel House , ,
rS � y1`f � f ir: ,
j J' 7 N :,
�- s s. CITY OF ATLANTIC BEACH
�. -. !�� ) 800 SEMINOLE ROAD
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: 16 -ELEC -314
Job Type: ELECTRIC ONLY
Description: REMODEL HOUSE
Estimated Value:
Issue Date: 2/9/2016
Expiration Date: 8/7/2016
PROPERTY ADDRESS:
Address: 65 19TH ST
RE Number: 169723 -1040
PROPERTY OWNER:
Name: SWEENEY,DAVID & PATRICIA, *
Address: 65 19TH ST
GENERAL CONTRACTOR INFORMATION:
Name: FRANKLIN ELECTRIC SERVICE
Address: 4 TALLWOOD RD QA JARRETT ADAM FRANKLIN
Phone: - -
FEES:
Trade Permit Base Fee $55.00
State Elec DCA Surcharge $2.00
State Elec DBPR Surcharge $2.00
Electrical Repairs $35.00
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
JOB ADDRESS: 6s /9 57
PERMIT #
JEA INFORMATION REQUIRED ON ALL PERMITS Z O 0 AMPS 170/70 VOLTS f PHASE
VALUE OF WORK $
NEW SERVICE 1 1 Overhead 1 1 Underground FP Underground up Pole
❑Residential (Main) Service
00 -100 amps 0101- 150amps 0151- 200amps ❑ amps # of Meters
0 Commercial (Main) Service
00 -100 amps ❑ 101- 150amps ❑ 151- 200amps ❑ amps OCT 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 ❑ 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:
DTHER 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$
LEPAIRS/1VIISCELLANEOUS
❑Replace Burnt /Damaged Meter Can ❑Safety Inspection ❑Panel Change ❑OH to UG
Xther: .i "i figa%:r nrs :,or i L4( S I ..t, t i V, Qt, ■0.k H o o 5 F r4de7EL
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
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 performance of
nstruction.
•operty Owners Name 5 Phone Number
ectrical Company P A.,t; it U4 Fikcif J fr.-y1.4)/ C,( Office Phone g 0 y 629 t/ I Z 5
). Address: 703 h0 r" 5r. 5. City Tkc. RP State re. Zip 372 5 D
sense Holder (Print): • i7G A. KU State Certifica ion/Registration # dion o
)tarizt ;'. ' I' g ', 1Ier _ / = �Ir4 �� � ��
s ; pu blic to ��' �
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a L Graham 9 ��j / /
,�< cmmissicn FF oasseBefo . me tin
i s s . • to j� 20 156'
''e Expires 02/14/201 - ' _ '
gnature of Notary Pu P