980 W 14TH ST - ELECTRICAL f.j r\.,,J
�� . . , J\�s, CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
r cr ATLANTIC BEACH, FL 32233
N� INSPECTION PHONE LINE 247-5814
40.21>f'
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-ELEC-737
Job Type: ELECTRIC ONLY
Description: ELECTRIC - TEMP POLE 100 AMPS, 120/ 240 VOLTS,
SINGLE PHASE
Estimated Value: $500.00
Issue Date: 3/28/2016
Expiration Date: 9/24/2016
PROPERTY ADDRESS:
Address: 980 W 14TH ST
RE Number: None
GENERAL CONTRACTOR INFORMATION:
Name: JOHN MANCINI ELECTRIC INC
Address: 2400 NE 10Th ST APT 402
Phone: - -
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Temporary Electrical Service $35.00
Trade Permit Base Fee $55.00
Total Payments: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233 (0 -�3
Ph(904)247-5826 Fax (904)247-5845
JOB ADDRESS: / ' O
''v /95* PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS `O G AMPS ` VOLTS \ PHASE
VALUE OF WORKS SO() , C O
NEW SERVICE ❑ Overhead ❑ Underground I v Underground up Pole
❑R 0-dential(Main)Service `
100 amps 0101-150amps ❑151-200amps D amps #of Meters
0 Commercial(Main)Service
00-100 amps 0 101-150amps 0 151-200amps 0 amps OCT Service amps
Conductor Type Size
❑Multi-Family(Main)Service
00-100 amps 0 101-150amps 0151-200amps I 1 amps #of Unit Meters
Temporary Pole ❑ \O 0 amps
SERVICE UPGRADE 0 amps U CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
0 100 amps D 150amps 0200amps 0 amps OCT Service amps
ADDITIONS,REMODELS,REPAIRS,BUILD-OUTS,ACCESSORY STRUCTURES,ETC.
Outlets/Switches: 0-30amps 31-100amps 101-200amps
Appliances: 0-30amps 31-100amps 101-200amps
A/C Circuits: 0-60amps 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
❑Swimming Pool ❑ Sign ❑Smoke Detectors_Qty OTransformers KVA OMotors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$ .D 0 D.
REPAIRS/MISCELLANEOUS
OReplace Bumt/Damaged Meter Can ❑Safety Inspection OPanel 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. / /►�n
?roperty Owners Name 7"), .-Id te G (� 1` Phone Number
?lectrical Company 0 011 N fr vW CI vj, ete (h4 Office Phones'S%f k YicFax
7,o.Address: �y�p w '.O ' City�o
i o ` v .�..0 State
cense Holder Print State CertificatifRegistration
# \-71
Votarized Signature of License Holder
TONI GINDLESPERGER B • 8 day of L11. V" 1,I: 21 s.
MY COMMISSION II FF 924951 �� �I�
°'DES:October s'2019c , ature of Notary Public
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