1365 Rose St - Electrical Only Repairs C 1.4.J.V.i. t `\ CITY OF ATLANTIC BEACH
s)
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 -365
Job Type: ELECTRIC ONLY
Description: ELECTRICAL - REPAIR, ADD CIRCUTS, ADD CAN LIGHTS
AND WATER HEATER
Estimated Value: $500.00
Issue Date: 2/12/2016
Expiration Date: 8/10/2016
PROPERTY ADDRESS:
Address: 1365 ROSE ST
RE Number: 171064 -0110
PROPERTY OWNER:
Name: SOVEREIGN INVESTMENT GROUP LLC, *
Address: 2728 DAVIE BLVD SUITE 134
GENERAL CONTRACTOR INFORMATION:
Name: JAX ELECTRICAL CONTRACTING INC
Address: 1839 LANE AVE SUITE 110 PAUL KEANE
Phone: - -
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Electrical Repairs $35.00
Switch Outlets $1.20
Trade Permit Base Fee $55.00
Total Payments: $95.20
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 �� C �
Ph (904) 247-5826 Fax (904) 247 -5845 �D — c
JOB ADDRESS: �' S� y � 1 PERMIT #
JEA INFORMATION REQUIRED ON ALL PERMITS AMPS VOLTS PHASE
VALUE OF WORK $ Soo •
NEW SERVICE 1 1 Overhead 1 I Underground nI Underground up Pole
OResidential (Main) Service
00 -100 amps 0101- 150amps ❑ 151- 200amps ❑ amps # of Meters
['Commercial (Main) Service
00 -100 amps 0101- 150amps 0151- 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.)
0100 amps 0150amps 0200amps ❑ amps OCT Service amps
ADDITIONS, REMODELS, REPAIRS, BUILD -OUTS, ACCESSORY STRUCTURES, ETC.
Outlets /Switches: 0 -3 Damps 31 -100 amps 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: l Z
OTHER ELECTRICAL PROJECTS
❑Swimming Pool ❑ Sign ❑Smoke Detectors Qty OTransformers -- KVA ❑Motors hp
±IRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts /amps VALUE OF WORK$
C EP AIRS/MISCELLANEOU g ,)
❑ la ce Burnt /Dania ed Meter Can ❑Safet Inspection ❑Panel Change 0011 to UG
-I— C. 4i -MJC,e Pre T pePM-t llZ ITS (ill �
C c t h e r : ftb r - v r � & a r l ft t e , - S � ' * u 4..1 614-T5 til l Q -4-GV
;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
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 ; U a ' CO Phone Number '� '
ectrical Company JAS( e" 1e c c a ( C 4(O 7 Office Phone me Fax ?ON 37 L( 0007(
). Address: 30 one_ AJf S . City 30Cit (DnuAP _State Et Zip 3 7a t Cp
sense Holder (Print): aL.) / /ean e State Certification /Registration # EC] 3( Yxt)c1 (z,
'tarized Signature of License Holder
Mala
:o4 Ft df%
R
� COMMISSION #FF230743 Before m e this h day of 1 (or a 20 ) (p
z. EXPIRES: May 14, tots Signature of Notary Public y
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