670 SHERRY ELEC 2016 - 1- 1-\i`,
�S ,4, �� CITY OF ATLANTIC BEACH
-, 800 SEMINOLE ROAD
� Z 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 -690
Job Type: ELECTRIC ONLY
Description: KITCHEN REMODEL 2 FIXTURES
Estimated Value:
Issue Date: 3/22/2016
Expiration Date: 9/18/2016
PROPERTY ADDRESS:
Address: 670 SHERRY DR
RE Number: 170398 -0000
GENERAL CONTRACTOR INFORMATION:
Name: CRAWFORD ELECTRIC
Address: P 0 BOX 51045 QA JOHN ROBERT CRAWFORD III
Phone: 904 - 241 -5591
FEES:
Trade Permit Base Fee $55.00
State Elec DCA Surcharge $2.00
State Elec DBPR Surcharge $2.00
Lighting Outlets, Including Fixtures $1.20
Total Payments: $60.20
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: 6 70 SA y �' - PERMIT #
JEA INFORMATION REQUIRED ON ALL PERMITS AMPS VOLTS PHASE
VALUE OF WORK $ MO. nv
NEW SERVICE I I Overhead I I Underground 11J Underground up Pole
❑Residential (Main) Service
❑O -100 amps ❑ 101- 150amps ❑ 151- 200amps ❑ amps # of Meters
❑Commercial (Main) Service
00 -100 amps 0101- 150amps ❑ 151- 200amps ❑ amps OCT 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.)
❑ l00 amps ❑ 150amps 0200amps ❑ amps OCT Service amps
tDDITIONS, REMODELS REPAIRS, BUILD -OUTS, ACCESSORY STRUCTURES, ETC.
Outlets /Switches: A 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:
)THER ELECTRICAL PROJECTS
❑ Swimming Pool ❑ Sign ❑ Smoke Detectors Qty ❑ Transformers KVA ❑ Motors hp
IRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts /amps VALUE OF WORK$
EPAIRS/MISCELLANEOUS
❑Replace Burnt /Damaged Meter Can ❑ Safety Inspection ❑Panel Change ❑ OH to UG
❑ Other: Xt. /v GAL' 4;4- J . l.. f ea,
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
d 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
:cified 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
Istruction. Lie, 3perty Owners Name i )% 4 /� g. /r1I Phone Number Y) 7 ^ 7$ 7. Z -/ -3
;ctricalCompany Crdter`S'ar1 e (e cif 'c Office Phone -2.* cs Fax bo -277. 903 7
. Address: 23o/ iYl rr,r IN r . A 1 1 City /v /,9 State /7 Zip 322 `(
ense Holder (Print): 71 X...) C 'J 1 State Certification/Registration # ,t C/3 Oct 2if y 2
tariz o : at d r9.14 t S e , e 0
_ y r: Shirley L Graham
A T My commission FF o e m this 2.."2-. da of / i ' .., l 20 )p of a Expires 02/14/2018 v ,
I_'' ature of Notary Publi , `l,