1545 FRANCIS UPGRADE SERVICE ' As CITY OF ATLANTIC BEACH
f 800 SEMINOLE ROAD
\ 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-694
Job Type: ELECTRIC ONLY
Description: SERVICE UPGRADE 200 AMP
Estimated Value: $3,000.00
Issue Date: 3/22/2016
Expiration Date: 9/18/2016
PROPERTY ADDRESS:
Address: 1545 FRANCIS AVE
RE Number: 172284-0000
PROPERTY OWNER:
Name: LYLES, TOMMY & SHIRLEY, *
Address: 13925 HUNTERWOOD RD
GENERAL CONTRACTOR INFORMATION:
Name: ISLAND ELECTRIC OF THE FIRST C
Address: 628 N 5TH AVE QA JOHNSON B REEP
Phone: - -
FEES:
Trade Permit Base Fee $55.00
State Elec DCA Surcharge $2.00
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State Elec DBPR Surcharge $2.00 V( I o o
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New Single Family Electrical $50.00 (R411
Total Paym n is $1 09.00 1 1 '
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PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION 6.s/ii,g
CITY OF ATLANTIC BEACH /I Q A ? S.
800 Seminole Rd, Atlantic Beach, FL 32233 (/
Ph(904)247-5826 Fax (904) 247-5845 z t/a s„. )6
JOB ADDRESS: 15 F ti 6I $ Sr- Al 1j PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS 2DOAMPS 21/0 VOLTS / PHASE
VALUE OF WORK$ 39.°6-64D
NEW SERVICE ❑ Overhead underground nJ Underground up Pole
❑Residential(Main)Service
fcl0-100 amps 0101-150amps [l51-200amps ❑ 700 amps #of Meters
[Commercial(Main)Service
00-100 amps ❑101-150am s
P p 0151-200amps ❑ amps OCT Service amps
Conductor Type Size
❑Multi-Family(Main)Service
00-100 amps ❑101-150amps ❑151-200amps ❑ amps #of Unit Meters
❑Temporary Pole ❑ amps
SERVICE UPGRADE CY( 7440 amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps ❑150amps 0200amps ❑ amps OCT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: l0 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: /if
OTHER ELECTRICAL PROJECTS
❑Swimming 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
-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
;onstruction.
?roperty Owners Name /VI AM .,A u E- Pelf S Phone Number
3lectrical Company t51-4I)h L'Q el -Or 714.. FiRSI (o43i L�G Office Phone 2 ( '7 Fax
-2o.Address: e.0- &X 50195 G City,JO. Pcf,( . State triA Zip 3225
License Holder (Print): -'JO State Certification/Registration# 67-, i 3OD7S?9-
Votarized Signature of License Holder
Before me this day of 20
Signature of Notary Public