212 MAGNOLIA ST - ELECTRICAL (-----
''- '�s � CITY OF ATLANTIC BEACH
;- ,, �� 800 SEMINOLE ROAD
KV _,' ATLANTIC BEACH, FL 32233
\
INSPECTION PHONE LINE 247-5814
�JJ1l9.r"
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-ELEC-619
Job Type: ELECTRIC ONLY
Description: elec for pool
Estimated Value:
Issue Date: 3/15/2016
Expiration Date: 9/11/2016
PROPERTY ADDRESS:
Address: 212 MAGNOLIA ST
RE Number: 170538-0000
PROPERTY OWNER:
Name: DALCERNO, RICHARD J & SUSANNE, *
Address: 212 MAGNOLIA ST
GENERAL CONTRACTOR INFORMATION:
Name: DAVID PRUETTES ELECTRICAL SVC.
Address: 331 -8 P PARKRIDGE AVE QA DAVID THOMAS PRUETTE
Phone: - -
FEES:
Trade Permit Base Fee $55.00
Swimming Pools $40.00
State Elec DCA Surcharge $2.00
State Elec DBPR Surcharge $2.00
Total Payments: $99.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
'I 1I nPh (904) 247-5826 /rFax (904) 247-5845
JOB ADDRESSt21a �q OL a 5-t. Han17 . �� , t " 3�? PERMIT#'10—POOL-141109
JEA INFORMATION REQUIRED ON ALL PERMITS AMPS VOLTS PHASE
VALUE OF WORK$
NEW SERVICE ❑ Overhead ❑ Underground I IJ Underground up Pole
Residential(Main)Service
0-100 amps 101-150amps 15I-200amps amps #of Meters
Commercial(Main)Service
0-100 amps 101-150amps 151-200amps amps CT 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 200amps 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:
OTHE ECTRICAL PROJECTS
wimming Pool Sign Smoke Detectors Qty Transformers KVA Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS
Replace Burnt/Damaged Meter Can Safety Inspection Panel Change OH to UG
Other:
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 Cero, RcWLrd Phone NumberQCt t 1
-006/
Electrical Company-baU iei Phi-°is L( i-tice -C t ceS Office Phone o/��)S Faxon`-7 -1
Co. Address: 331 P4f-kn�dy. City 0c nc/ Par14- State PL...Zip 3CX€5
License Holder(Print): T 1i d f u tte- ,:-,,ertification/Registration# E p1'3Z3
Notarized Signature of License Holder
41"°` Sworn and ubscribed before me this t� of 20 I
C1 f0 ROBERTS a'w
� � �Ml'COMMISSION H FF IS3136 �/
+,off,, F.x!':RES.August 21,2018 Signature of Notary Public ���