312 4TH ST - ELECTRIC s 0_"Lyr7v�
,a `' 1, . s, CITY OF ATLANTIC BEACH
s) 800 SEMINOLE ROAD
J Z ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
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ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-ELEC-920
Job Type: ELECTRIC ONLY
Description: ELECTRIC REWIRE - UNIT A
Estimated Value:
Issue Date: 4/20/2016
Expiration Date: 10/17/2016
PROPERTY ADDRESS:
Address: 312 4TH ST
RE Number: 169812-0000
PROPERTY OWNER:
Name: HOLLOWAY ET AL, MARGARET M
Address: 1200 OCEANFRONT
GENERAL CONTRACTOR INFORMATION:
Name: KNIGHT ELECTRIC LLC
Address: 908 S 11TH AVE QA MARK STEVEN KNIGHT
Phone: - -
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: $94.00
PER!1IIT IS APPROVED ONLY IN ACCORDANCE WITII ALL CITY OF ATLANTIC BEACH ORDINANCES AND 771E FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CrI'Y OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233 J _ E� �
Ph(904) 247-5826 Fax (904) 247-5845 �
JOB ADDRESS: CIA S`rrc -ir ,- ((J N t T 3(0 PERMIT# < ° C2/
JEA INFORMATION REQUIRED ON ALL PERMITS a16 AMPS 2die 2d/e VOLTS 1 PHASE
VALUE OF WORK$
NEW SERVICE n Overhead n Underground 1-11 Underground up Pole
❑Residential(Main)Service
❑0-100 amps 0101-150amps ❑151-200amps 0 amps #of Meters
❑Commercial(Main)Service
❑0-100 amps ❑101-150amps ❑151-200amps ❑ amps OCT Service amps
Conductor Type Size
❑Multi-Family(Main)Service
00-100 amps ❑101-150amps ❑151-200amps 0 amps #of Unit Meters
❑Temporary Pole ❑ amps
SERVICE UPGRADE 0 amps O CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
0100 amps 0150amps 0200amps 0 amps OCT Service amps
tDDITIONS,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:
)THER ELECTRICAL PROJECTS
0 Swimming Pool O Sign ❑Smoke Detectors Qty 0 Transformers KVA 0 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 UGH to UG
Mother: Man--
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
rstruction.
Dperty Owners Name Phone Number
:ctrical Company 11s�,r fit- --ie L LL-L Office Phone � - 1 Sa/ Fax 2Y�� ��"3
.Address: g �/�' � ✓�'� City ■ ( �c�. State Zip 322 S�6
ense Holder (Print : y i C M Lr State Certif:at ion/Registration# �2(7Gl2tLJ— ��� ONIGIN GER �tarized Sri_ -' '°+e o dot I t 4 ..c;::•_1 a: EXPIRES:October 8,2019
'?R (t Bonded ThruNolaYPubk.tp�:j_I,ethis
�% day ,��� !�1�i 20
Signature of Notary Public Q, OP /7