312 4TH ST - ELECTRIC (2) � aJJr
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• bv' , CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
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-921
Job Type: ELECTRIC ONLY
Description: ELECTRIC - REWIRE
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: $94.00
PERMII•I' IS APPROVED ONLY IN ACCORDANCE WIIli ALL CI1'1' OF AI1.1NIIC BEACH ORDINANCES AND 'I'itE FLORIDA
BUILDING CODES.
ELECTRICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd, Atlantic Beach, FL 32233 I ��
�Ph—(904) 247-5826 Fax (904) 247-5845 — 9 z
JOB ADDRESS: 7/ Z t ['c. �I_ Q PERMIT#
JEA INFORMATION REQUIRED ON ALL PERMITS (2--W AMPS 2y() VOLTS / PHASE
VALUE OF WORK$
NEW SERVICE ❑ Overhead n Underground I 11 Underground up Pole
❑Residential(Main)Service
❑0-100 amps 17101-150amps ❑151-200amps C amps #of Meters
Ell Commercial(Main)Service
00-100 amps ❑101-150amps ❑151-200amps ❑ amps ❑CT Service amps
Conductor Type Size
El Multi-Family(Main)Service
❑0-100 amps 17101-150amps [115 1-200amps ❑ amps #of Unit Meters
❑Temporary Pole (1 amps
SERVICE UPGRADE [ 1 amps ❑ CT Service amps
NEW FEEDER(ADDITIONS,ACCESSORY STRUCTURES,ETC.)
❑100 amps `-1150amps 0 200amps = 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
LI Swimming Pool ❑ Sign C.1 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 CPanel 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.
Property Owners Name t� Phone Number �1
Electrical Company 1?Jtc kr <<- LL--C- Office Phone 297-htti Fax
Co. Address: 90%, (( ,1- c S, City 1/'4/ ���• State Ft. Zip 7ZCO
License Holder (Print): �I-torn 16,41 lAc State Certification/Registration# ER 30(Z5Z7
Notarized Signature of License Holder L/ ' _
.4.1,"."'",4,,.. TONI GINDLESPERGF o ; me this 2-' day o ., • d.A •0 ( .
'= MY COMMISSION•FF 92495 I 11111161°�; /r •
+�' EXPIRES:October 6, I:19,
'1%�:� ebubrcrund. re of Notary Public _�
?' d` Bonded ThN NOUry