2001 SEMINOLE RD 2016 ELEC `SCITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
J s 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-550
Job Type: ELECTRIC ONLY
Description: ELECTRICAL - GROUND GAS PIPE FOR FIREPLACE
Estimated Value:
Issue Date: 3/7/2016
Expiration Date: 9/3/2016
PROPERTY ADDRESS:
Address: 2001 SEMINOLE RD
RE Number: 169723-0012
PROPERTY OWNER:
Name: MCKINNON, DANIEL J
Address: 2001 SEMINOLE RD
GENERAL CONTRACTOR INFORMATION:
Name: DUTCHER ELECTRIC INC
Address: 1122 NORTH 3RD AVE QA AUSTIN JOHN DUTCHER
Phone: - -
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Electrical Repairs $35.00
Trade Permit Base Fee $55.00
Total Payments: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
Ph(904)247-5826 Fax (904 247-5845 - �
JOB ADDRESS: 2 0 r PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS AMPS VOLTS PHASE
VALUE OF WORIC$
NEW SERVICE ❑ Overhead ❑ Underground ❑T Underground up Pole
❑Residential(Main) Service
00-100 amps 0101-150amps 0151-200amps ❑ amps #of Meters
❑Commercial(Main) Service
00-100 amps 0101-150amps 0151-200amps ❑ amps OCT Service amps
Conductor Type Size
❑Multi-Family(Main)Service
00-100 amps 0101-150amps 0151-200amps ❑ amps #of Unit Meters
❑Temporary Pole ❑ amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps ❑150amps 0200amps ❑ amps ❑CT 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
❑Swimming Pool ❑ Sign El 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 ❑Panel Change DOH to UG
096ther: I ' --. k
;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 perfonnance of
nstruction. /
operty Owners Name a Phone Number 6651�S
ectrical Company r� C Office Phone —5y
Fax
). Address: 2 " City( ;AX ,q4X State Zip -57Z2
tense Holder (Print): t Certification/Registration#4�2/3U/Zf-2
?tarized Signature 0, Licen
TONI GINFober
ERGER
My cot is day o 2
EXPIRES:
Bonded Th No P fie Underwriters
Rf;r.• ary Public