1369 Rose St - Electric Only Repairs v 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 -364
Job Type: ELECTRIC ONLY
Description: ELECTRIC - REPAIR, ADD CAN LIGHTS, NEW WATER
HEATER & CIRCUTS
Estimated Value: $500.00
Issue Date: 2/12/2016
Expiration Date: 8/10/2016
PROPERTY ADDRESS:
Address: 1369 ROSE ST
RE Number: None
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
Ph (904) 247 -5826 Fax (904) 247 -5845 1 (p - EL-GC 3 ( 0 4
JOB ADDRESS: 1 3 Coq 1?-0 -- PERMIT #
2-2 33
JEA INFORMATION REQUIRED ON ALL PERMITS AMPS VOLTS PHASE
VALUE OF WORK $
NEW SERVICE ❑ Overhead ❑ Underground rlJ Underground up Pole
1 Residential (Main) Service
0 -100 amps 101- 150amps ,151- 200amps 1 amps # of Meters
_Commercial (Main) Service
_0 -100 amps 101- 150amps 1 151- 200amps amps 1 C Service amps
Conductor Type Size
Multi- Family (Main) Service
10 -100 amps 1101- 150amps 1151- 200amps 1 amps # of Unit Meters
Temporary Pole E amps
SERVICE UPGRADE '1 amps 1 CT Service amps
NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.)
100 amps 1150amps 1200amps _ amps 1CT 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: 2--
OTHER ELECTRICAL PROJECTS
1 Swimming Pool Sign ❑ Smoke Detectors Qty 1; Transformers KVA 1 Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts /amps VALUE OF WORK $
PAIRS/MISCELLANEOUS
1Replace Burnt/Damage Meter Can 11 Safety Inspection 1Panel Change 10H to UG
iabther: f }0 6, i'�►l e'�oW I� 1 R T C[ TzCtJt j i 1 CAW I x I Y►9 IIJ .1) 4---WATFe H
Permit 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
read 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
specified 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
construction.
Property Owners Name 01-IkX J 0 - 1 k Phone Number S 3 3 61
Electrical Company T Q v ( 4 ' ('- c ( Con C ..:i Office Phone 9 c acsSaST ax `04 31 C4.0
Co. Address: I • y - G c L cY1 1e State Ft- Zip -- Sc)8 (C)
License Holder (Print): r ) K1 cane_ State Certification/Registration #
Notarized Signature of License Holder
" Maiaea Robidart Sworn and subscribed before me this day of h�� 20 I (e)
,1 - ' COMMISSION EX EXPIRES: May 14, 2019
" Signature of Notary Public " . " -{71-1 -k %,15 ,� PIRES: Mry 14, 2019 g Y
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