1270 OCEAN ELEC r ` ` : J `
s. CITY OF ATLANTIC BEACH
-7 "_ s) 800 SEMINOLE ROAD
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 -1055
Job Type: ELECTRIC ONLY
Description: 8 FIXTURES
Estimated Value:
Issue Date: 5/5/2016
Expiration Date: 11/1/2016
PROPERTY ADDRESS:
Address: 1270 OCEAN BLVD
RE Number: 171823 -0000
PROPERTY OWNER:
Name: STONE,MITCHELL A & CHRISTINE L, *
Address: 1270 OCEAN BLVD
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
Lighting Outlets, Including Fixtures $4.80
Total Payments: $63.80
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 � I
800 Seminole Rd, Atlantic Beach, FL 32233 I (� ` i
Ph (904) 247 -5826 Fax (904) 247 -5845
2 l 0
(
JOB ADDRESS: � 7a �'_ 6j` ) I
G�41� v " PERMIT #
JEA INFORMATION REQUIRED ON ALL PERMITS AMPS / VOLTS 2
PHASE
VALUE OF WORK $
NEW SERVICE n Overhead n Underground 1 11 Underground up Pole
❑Residential (Main) Service
00 -100 amps ❑ 101- 150amps ❑ 151- 200amps ❑ amps # of Meters
❑Commercial (Main) Service
❑O -100 amps ❑ 101- 150amps ❑ 151- 200amps ❑ amps OCT Service amps
Conductor Type Size
❑Multi- Family (Main) Service
❑ 0 -100 amps ❑ 101- 150amps ❑ 151- 200 amp s ❑ amps # of Unit Meters
❑Temporary Pole ❑ amps
SERVICE UPGRADE ❑ amps ❑ CT Service amps
NEW FEEDER (ADDITIONS, ACCESSORY STRUCTURES, ETC.)
❑ 100 amps ❑ 150amps 0200amps ❑ amps ❑CT Service amps
ADDITIONS, REMODELS, REPAIRS, BUILD -OUTS, ACCESSORY STRUCTURES, ETC.
Outlets /Switches: 2- 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: co
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 IA 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.
Property Owners Name S /4j1! Phone Number
Electrical Company 4,P/Z E / J ./ / i> P' Office Phone 22_3 - / /SV3 Fax 373 -
Co. Address: 2/ / `' • / "Uf'CO6� if , City 0 t State7/ Zip 3 2_
License Holder (Print): 4 C ' ' L . /6.'2 ` _ rte Certification/Registration #
Notarized Signature of License Holder / I �,1
Before , e this day of 20
Signature of Notary Public