342 SKATE RD ELEC -S\ CITY OF ATLANTIC BEACH
;-. ..$) 800 SEMINOLE ROAD
J - �`' ATLANTIC BEACH, FL 32233
P) P
INSPECTION PHONE LINE 247 -5814
Jif1)r
ELECTRICAL PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247 -5814
JOB INFORMATION:
Job ID: 16 -ELEC -1012
Job Type: ELECTRIC ONLY
Description: ELECTRICAL - REPAIRS DUE TO FLOODING
Estimated Value:
Issue Date: 5/2/2016 I
Expiration Date: 10/29/2016
PROPERTY ADDRESS:
Address: 342 SKATE RD
RE Number: 171661 -0000
PROPERTY OWNER:
Name: LOVE, TRUST
Address: 342 SKATE RD
GENERAL CONTRACTOR INFORMATION:
Name: ELECTRIC PLUS
Address: 11199 LAKE BLUFF RD QA WILLIAM SHREWSBURY
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
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 C �
�}} Ph (904) 247 -5826 Fax (904) 247 -5845 1 CD ^ELE Q' -) o a
JOB ADDRESS: 1 3 '1 D- 5 ka.- -3 D-33 PERMIT #
JEA INFORMATION REQUIRED ON ALL PERMITS AMPS VOLTS PHASE
VALUE OF WORK $
NEW SERVICE ❑ Overhead ❑ Underground IJ Underground up Pole
❑Residential (Main) Service
❑0 -100 amps ❑ 101- 150amps ❑ 151- 200amps ❑ amps # of Meters
❑ Commercial (Main) Service
00 -100 amps ❑ 101- 150amps ❑ 151- 200amps ❑ amps OCT Service amps
Conductor Type Size
❑ Multi - Family (Main) Service
1110 -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 ❑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
[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: C lcc . rep. dv e +o Fl ocd 1;-.5 fC 1 c c r t Om
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 C E' 1 i p Phone Number Aar 3 ?CJ - WOO
Electrical Company C U 5 (� Office Phone E �'1 Fax
Co. Address: 1 �( c( Lckke & U Rd. - )5
i City I State R, Zip 3 7
License Holder (Print): L 1 ■, \ at^'\ �� Shrewslir S. te Ce 'fication/Registration # ER /36 /W3
Notarized Signature of License Holder 0
— this day of j I /r i 20
;'a TONI GINDLESPERGER
MY COMMISSION I :�
N 495
ur of Notary Public i e _��
EXPIRES: Octob
, ,�F !
Bonded 'Nu Notary Public Underwriters