290 BEACH AVE - ELECTRIC -S r\.1`1:r
�sf CITY OF ATLANTIC BEACH
•f 5-) 800 SEMINOLE ROAD j ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
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ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 15-ELEC-2473
Job Type: ELECTRIC ONLY
Description: new service 200 amps
Estimated Value:
Issue Date:
11/2/2015
Expiration Date: 4/30/2016
PROPERTY ADDRESS:
Address: 290 BEACH AVE
RE Number: 170196-0010
PROPERTY OWNER:
Name: PITLER, ANDY
Address: 273 OCEAN BLVD
GENERAL CONTRACTOR INFORMATION:
Name: ERICKSON ELECTRICAL CONTRACTOR
Address: 2807 ST JOHNS QA FRANK W ERICKSON
Phone: 904-735-9271
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
New Single Family Electrical $70.00
Trade Permit Base Fee $55.00
Total Payments: $129.00
j
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
From:BOSCO BUILDING CONTRACTORS INC 904 241 0326 10/19/2015 12:27 #220 P. 001/001
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
Ph 904) 247-5826 Fax (904) 247-5845
JOB AD 0 ' S: 2c\(�0 , 4 , \l a. PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS (iO AMPS 4O VOLTS PHASE
VALUE OF WORK$
NEW SERVICE ❑ Overhead ❑ Underground J Underground up Pole
❑Residential(Main) Service
00-100 amps LJ 101-150amps 51-200amps L amps #of Meters
❑Commercial(Main)Service
Li 0-100 amps ❑101-150amps .rl 151-200amps ❑ amps LCT Service amps
Conductor Type Size
❑Multi-Family(Main)Service
00-100 amps ❑101-150amps /.7151-200amps LI amps #of Unit Meters
[1 Temporary Pole rl amps
SERVICE UPGRADE L amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES, ETC.)
11100 amps ❑150amps ❑200amps D 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:
OTHER ELECTRICAL PROJECTS
LSwimming Pool D Sign ❑Smoke Detectors Qty :Transformers KVA nMotors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
El Replace Burnt/Damaged Meter Can Li Safety Inspection ❑Panel Change DOH to UG
❑Other:
'ermit 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
ead 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
pecified 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
nnstruction.
'roperty Owners Name CO f O � 0
�� ����/�- Phone Number Vic V
'electrical Company /V----\C X~,0 t..--C v J cre_`� Office Phone A t U FaxZ41i O z(O
;o.Address:Z M&wozi- El. 1 ` City &V. .9-AAA. Staten Zip
Acense Holder (Print): ' >i..A.t'J L. Ot. 'State Certification/Registration -000 0
Notarized Signature of License Holder ."
Sworn and subscribed befor: 1- this day of_ 20