237 MAGNOLIA ST - ELECTRIC PANEL CHANGE C' Imo';: S, CITY OF ATLANTIC BEACH
l 800 SEMINOLE ROAD
lip 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-463
Job Type: ELECTRIC ONLY
Description: PANEL CHANGE
Estimated Value:
Issue Date: 2/23/2016
Expiration Date: 8/21/2016
PROPERTY ADDRESS:
Address: 237 MAGNOLIA ST
RE Number: 170545-0050
PROPERTY OWNER:
Name: SUMMERS, COLLIER
Address: 237 MAGNOLIA ST
GENERAL CONTRACTOR INFORMATION:
Name: BILL THOMPSON ELECTRIC CO, INC
Address: 49 WEST 7TH ST QA WILLIAM R. THOMPSON, IV
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: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
Ph(904) 247-5826 Fax (904) 247-5845
JOB ADDRESS: 2 7 147A o/ 4 PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS 7)O AMPS 2 Vr VOLTS / PHASE
VALUE OF WORK$ S2 6"6
NEW SERVICE ❑ Overhead n Underground I JJ Underground up Pole
❑Residential(Main)Service
00-100 amps 0101-150atnps ❑151-200amps 0 amps #of Meters
❑Commercial(Main)Service
00-100 amps 0101-150amps ❑151-200amps 0 amps OCT Service amps
Conductor Type Size
❑Multi-Family(Main)Service
00-100 amps 0101-150amps ❑151-200amps 0 amps #of Unit Meters
❑Temporary Pole 0 amps
SERVICE UPGRADE 0 amps 0 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: 0-30amps 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 0 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 P. 'anel Change OOH 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 Name '/ '/c°!— } 74//Ii/J'Pr/1' Phone Number
ectrical Company tj// i. U7j f�/r 74G Office Phone '91-- C,/ Fax 7.C".dS
y
r. Address: 7./ ie./ 7 S --C, ( City 4 y State Zip J Z-
sense Holder (Print): / L r 09'1 S ate Certification/Registration# /..3, 7 Z/7'
?tarized Signature of License Hodder ��j� Ji/.. -
Before me this day IrMEINW
Signature of Notary Pu •.‘441,..,115.11111r4&�a`