464 SARGO RD - ELECTRIC -jyV1J.
' ' '' �S\ CITY OF ATLANTIC BEACH
2 800 SEMINOLE ROAD
J 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-646
Job Type: ELECTRIC ONLY
Description: CONNECT 3 APPLIANCES
Estimated Value:
Issue Date: 3/16/2016
Expiration Date: 9/12/2016
PROPERTY ADDRESS:
Address: 464 SARGO RD
RE Number: 171541-0000
PROPERTY OWNER:
Name: REYNOLDS, MATTHEW B
Address: 3534 SHINNECOCK LN
GENERAL CONTRACTOR INFORMATION:
Name: SEASIDE ELECTRICAL CONTRACTORS
Address: 12381 APPLE LEAF DR QA CLARK GEISSMAN
Phone: - -
FEES:
Trade Permit Base Fee $55.00
State Elec DCA Surcharge $2.00
State Elec DBPR Surcharge $2.00
Electrical Appliances $6.00
Total Payments: $65.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC REACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
I
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
Ph(904) 247-5826 Fax (904) 247-5845
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JOB ADDRESS: (`� (54/5"6'G 1&Ci9.J , L/}.t vi l6 &A 322 35 PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS /I-6 AMPS OW VOLTS I PHASE
oa
VALUE OF WORKS 1 ?
NEW SERVICE ❑ Overhead ❑ Underground I 11 Underground up Pole
Residential(Main)Service
H0-100 amps 101-150amps :151-200amps amps #of Meters
' Commercial(Main)Service
1 10-100 amps 101-150amps 1 1151-200amps amps .1CT Service amps
Conductor Type Size
Multi-Family(Main)Service
I :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.)
1100 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:
OTHER ELECTRICAL PROJECTS
I Swimming Pool Sign Smoke Detectors_Qty I Transformers KVA I Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans) _
Qty volts/amps VALUE OF WORK S 5
REPAIRS/MISCELLANEOUS
Replace Burnt/Damaged Meter Can/ I Safety Inspection Panel Change OH to UG
Other: �rl�-c.1` A')fc,e-4) �/w -f ?Ylpv1-4-
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 /l�9rHCR/8. 2 Et/,Vc U 5 Phone Number j'6 i) ,-V,��
Electrical Company,ci�-s L leei/L,(. / n►_/ 1 7.k c Office Phone S-/'j - 6 S iS Fax 4 VY' 3`%(l
Co.Address: /262v -3 2.2 4-d-- /31.i 27c City , (4' State r-/-- Zip 32-VC
License Holder(Print): ez�Q k ��/TSM, * State Certification/Registration# ER 130 I i S`7
Notarized Signature of License Holder /f i '� r
z g l ?.
ALEXANDER SCOTT LAWTON Sworn and subscribed before me this U) f"- day of Mc,c-�. 20 l(0
,471•4.„_. TA Commission#FF 905087
WExpires July 30,2019 Signature of Notary Public -�
4,4 i.. Banded TMO Troy f En n u..,o.800-365.7019
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