1877 Beach Ave - 9 Fixtures Electric S\ CITY OF ATLANTIC BEACH
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 -342
Job Type: ELECTRIC ONLY
Description: P FIXTURES ELEC
Estimated Value:
Issue Date: 2/11/2016
Expiration Date: 8/9/2016
PROPERTY ADDRESS:
Address: 1877 BEACH AVE
RE Number: 169682 -0000
PROPERTY OWNER:
Name: PIETAN, JERAL H
Address: 1877 BEACH AVE
GENERAL CONTRACTOR INFORMATION:
Name: LORE ELECTRICAL CONTRACTORS
Address: 210 N ROSCOE BLVD QA MICHAEL LEE LORE
Phone: - -
FEES:
Trade Permit Base Fee $55.00
State Elec DCA Surcharge $2.00
State Elec DBPR Surcharge $2.00
Lighting Outlets, Including Fixtures $5.40
Total Payments: $64.40
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 I ) I ( te
v 1/
800 Seminole Rd, Atlantic B each, FL 32233 , 4
Ph (9 4) 247 - 5826 Fax (904) 247 -5845
JOB ADDRESS: /g 77 v -
r -' C PERMIT #
JEA INFORMATION REQUIRED ON ALL PERMITS ,!`: AMPS - �J VOLTS
PHASE
r
VALUE OF WORK $ iS OD?
n
NEW SERVICE 1 I Overhead 1 1 Underground 11J Underground up Pole
❑Residential (Main) Service
❑ 0 -100 amps 1 101- 150amps ❑ 151- 200amps ❑ amps # of Meters
❑ Commercial (Main) Service
00 -100 amps 0101- 150amps 0 151- 200amps ❑ amps OCT Service amps
Conductor Type Size
[liquid-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 OCT 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: 9.
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$
tEPAIRS/MISCELLANEOUS
- ❑Replace Burnt /Damaged Meter Can ❑Safety Inspection ❑Panel Change ❑OH to UG
❑ Other:
=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 performance of
nstruction.
•operty Owners Nam- Phone Number —R
Mr
Company . AWE E _t., Office hone 273 - / /`& Fax ,323-9Mr
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..ense Holder (Print): /I, dt,eicl L, 1_,,,tc _ / ate Certification/Registration # CC /3 e066 F Z
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a re of Notary Public