130 CLUB DR NEW ELEC SERVICE CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
j r 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-449
Job Type: ELECTRIC ONLY
Description: NEW SERVICE 200 AMPS
Estimated Value:
Issue Date: 2/24/2016
Expiration Date: 8/22/2016
PROPERTY ADDRESS:
Address: 130 CLUB DR
RE Number: 170319-0000
PROPERTY OWNER:
Name: Shields, David
Address: 53 Oceanside DR
GENERAL CONTRACTOR INFORMATION:
Name: KNIGHT ELECTRIC LLC
Address: 908 S 11TH AVE QA MARK STEVEN KNIGHT
Phone: - -
FEES:
New Single Family Electrical $70.00
Trade Permit Base Fee $55.00
State Elec DCA Surcharge $2.00
State Elec DBPR Surcharge $2.00
Total Payments: $129.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
Ph(904) 247-5826 Fax (904) 247-5845
JOB ADDRESS: C\U Vl Dr- PERMIT# 15 — a
JEA INFORMATION REQUIRED ON ALL PERMITS "acx� AMPS _VOLTS PHASE
VALUE OF WORIC$
NEW SERVICE ❑ Overhead ❑ Underground P Underground up Pole
❑Residential(Main) Service
00-100 amps 0101-150amps )1151-200amps ❑ 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.)
❑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:
ETHER 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$
:EPAIRS/MISCELLANEOUS
❑Replace Burnt/Damaged Meter Can El Safety Inspection ❑Panel Change OOH to UG
❑Other:
: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 pen-nit 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 O' C'U , S�t e
C Phone Number
ectrical Company Office Phone V&8'� Fax
>. Address: City 732(X gd' State TL_Zip 20d5Q
sense Holder (Print): 'L' -P State Certification/Registration# 1,30) -15 a3
?tarized Signature of License Hodder
Before me this day of 20
Signature of Notary Public