109 BEACH AVE NEW ELEC SERVICE GARAGE ,�' '�'` �� v CITY OF ATLANTIC BEACH
_ ) 800 SEMINOLE ROAD
7 :'<ily " ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247 -5814
\0111
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247 -5814
JOB INFORMATION:
Job ID: 16 -ELEC -923
Job Type: ELECTRIC ONLY
Description: NEW SERVICE 200 AMPS
Estimated Value: $10,000.00
Issue Date: 4/20/2016
Expiration Date: 10/17/2016
PROPERTY ADDRESS:
Address: 109 BEACH AVE
RE Number: 170212 -0000
PROPERTY OWNER:
Name: FECHTEL FAMILY JNT VENT ET AL
Address: 6830 MEADOW RD
GENERAL CONTRACTOR INFORMATION:
Name: LORE ELECTRICAL CONTRACTORS
Address: 210 N ROSCOE BLVD QA MICHAEL LEE LORE
Phone: - -
FEES:
Trade Permit Base Fee $55.00
State Elec DCA Surcharge $2.00
State Elec DBPR Surcharge $2.00
New Single Family Electrical $70.00
Total Payments: $129.00
I
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORID :1
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233
P (904) Fax (904) 247 -5845
JOB ADDRESS: � & PERMIT #
JEA INFORMATION REQUIRED ON ALL PERMITS Z AMPS 2 -Yc3VOLTS l PHASE
V LUE OF WORK $ � dr-0-0
NEW SERVICE ❑ Overhead ErUnderground nT Underground up Pole
❑ Residential (Main) Service
❑0 -100 amps ❑ 101- 150amps . 51- 200amps ❑ amps # of Meters
❑ Commercial (Main) Service
1110 -100 amps ❑ 101- 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.)
❑ 100 amps ❑ 150amps ❑200 amp s ❑ 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 ❑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
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. 6;4 / � Property Owners Name ��O�t°&" Phone Number
Electrical Company /-0-g. /� c� l 64,4_ JA' c e - Office Phone 273-1/V3 Fax 373 - 9012
Co. Address: 270 A/ Arced: /546' • City -Ut/F ird • State 7 Zip 3 2 di l `
License Holder (Print): (.Rid (. � 1.. hc?,2 ate Certification/Registration # j 3 c) 0 6 6 71°
Notarized Signature of License Holder
efore me this a0 da . ciEseAl. �4f 20/
Nota Public G State h of Florida
/
� Shirle L
c` ., 4` My Commission ra F F 086990 - ignature of Notary Pub .ta
Expires 02/14/2018