469 ATLANTIC BLVD - ELECTRIC REPAIR (10 A/C ROOF TOP UNITS) 1; ::;:i CITY OF ATLANTIC BEACH
;_-- "may;:-_ 800 SEMINOLE ROAD
J -". ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
N
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-ELEC-767
Job Type: ELECTRIC ONLY
Description: ELECTRICAL REPAIR - A/C DISCONNECT ON ROOF TO 10
UNITS
Estimated Value: $1,500.00
Issue Date: 3/31/2016
Expiration Date: 9/27/2016
PROPERTY ADDRESS:
Address: 469 ATLANTIC BLVD
RE Number: 170690-0000
PROPERTY OWNER:
Name: DIAMOND REAL ESTATE PROPERTIES
Address: 6517 LOU DRIVE S
GENERAL CONTRACTOR INFORMATION:
Name: NGUYEN ELECTRIC CONTRACTOR, LLC
Address: 1602 Lockend RD
Phone: 904-612-9135
FEES:
State Elec DBPR Surcharge $2.00
State Elec DCA Surcharge $2.00
Electrical Repairs $35.00
Trade Permit Base Fee $55.00
Total Payments: $94.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLAN'T'IC BEACII
800 Seminole Rd, Atlantic Beach, FL 32233
Ph (904) 247-5826 Fax (904) 247-5845 I Co `ESC -7(7
JOB ADDRESS: /67 ,/7#//c N,,,,/ PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS AMPS VOLTS PHASE
VALUE OF WORK$ /.SOD, ert-
NEW SERVICE ❑ Overhead n Underground I JJ Underground up Pole
1 Residential(Main) Service
10-100 amps 1 :101-150amps C 151-200amps amps #of Meters
I iCommercial(Main) Service
:0-100 amps Hi 101-150amps I :151-200amps f 1 amps CT Service amps
Conductor Type Size
I Multi-Family(Main)Service
0-100 amps 1101-150amps 1151-200amps '__ amps #of Unit Meters
-Temporary Pole amps
SERVICE UPGRADE - amps I CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
i100 amps 1 150amps 1200amps amps C_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: iV 0-60amps 61-100amps
Heat Circuits: # circuits @ kw
Number of Lighting Outlets, Including Fixtures:
OTHER ELECTRICAL PROJECTS
❑Swimming Pool i Sign Smoke Detectors Qty I:Transformers KVA Motors hp
FIRE ALARM SYSTEM (Requires 3 sets of plans)
Qty volts/amps VALUE OF WORK$
REPAIRS/MISCELLANEOUS 0 UN 6?S
Replace Burnt/Damaged Meter Can )Safety Inspection/ 1Panel Change i 10 to UG
I:;Other: !ep4.ir a &pt e.e Ar v►`rseermer eli Gi✓1 zzeo-111 0,,
'ermit 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 Dl Peg--( akieRropor4initcrne Number !b 4- cat Z-9 /3 S
'electrical Company //fare,/ 7, ‘e a2714G7C Office Phone Fax
;o. Address: /GO„. z ot..4€4407 A' City Jar,k sox vc/( State Fl Zip .212/
,icense Holder Print
( ) VG/ /LI��«. LN State Certification/Registration# EC / 3p0 73,5--
Jotarized Signature of License . 1 ' •r ..
411*-: TON(GISSIFSPERGER 3 l day o in k !I1 I A 20 1
MY COMMISSION#FF 92495tH: re me this
EXPIRES:October 6,2019 y , _
�����•` a�a°aThtir�,°nP°b�u°a°mac° '. ature of Notar Public
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